Why is there so much confusion about pricing and payment for COVID-19 tests?Įarly on in the pandemic, in March, several faculty members at Johns Hopkins – myself included – recommended a very different approach to the piecemeal strategy adopted by the federal government. As a result, it is possible that the uninsured could still be charged for testing by their healthcare provider. There is no requirement that clinics or physicians avail themselves of this program. ![]() Details about this program are available here. The federal government has provided a path for reimbursement for COVID-related testing and treatment expenses for the uninsured, including testing. An insurance provider might decide that certain types of testing (such as testing after a trip) may not be considered “medically appropriate.” Another reason is that federal guidance only requires reimbursement for “medically appropriate” testing. The law does not require insurers to cover the cost of the medical consultation or doctor’s referral that may be required before a test will be administered. This unpredictability of cost is part of the larger, fragmented healthcare system in the United States that leads to a wide variability in medical expenses.ĭoes insurance cover the costs of a COVID-19 test?įederal law requires insurers to cover the costs of COVID-19 tests, but unfortunately patients are still being charged for related expenses. The cost for a COVID-19 test may vary a great deal based on type of laboratory where the test is processed, region of the country, insurance provider, and other factors. Again, any test would also likely require additional charges for specimen collection and a physician’s visit, which could potentially add to the cost significantly.ĭoes the cost vary depending on where you live? For those who end up paying out of pocket, there was a smaller range of $36 to $180 per test. Currently, the Medicare reimbursement rate for a COVID-19 test is either $51 or $100, depending on the type of test offered. An investigation by the Kaiser Family Foundation determined that the cost of a test can range anywhere from $20 to $850, with $127 being the median cost. ![]() How much does a viral test for COVID-19 cost? To understand more about the nuances of insurance coverage and expenses that accompany COVID-19 testing, we reached out to Josh Sharfstein, Professor of Practice and Vice Dean for Public Health Practice and Community Engagement at the Johns Hopkins Bloomberg School of Public Health. As the demand for COVID-19 testing has grown, so too have questions about who bears the cost. Testing allows public health officials to track the virus’s path, understand disease prevalence, and determine the need for isolation and quarantine. Widespread testing for the novel coronavirus has proven an essential tool in fighting the spread of the disease.
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