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TO: Physicians, FQHCs, RHCs, Independent Labs, Hospitals, and
ADPH
As Medicaid continues to monitor
the COVID-19 emergency in Alabama, the Agency is adding the testing procedure
for coverage below:
- 87426 - Infectious agent antigen detection by
immunoassay technique, (e.g., enzyme immunoassay [EIA], enzyme-linked
immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA])
qualitative or semiquantitative, multiple-step method; severe acute
respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19])
- Note: Providers with a valid CLIA certificate of waiver indicator
may bill procedure 87426 with modifier QW.
Providers may begin submitting
claims on August 24, 2020 for dates of service on or after June 25, 2020.
Reimbursement
rates for the COVID-19 testing and specimen collection procedure codes can be
found on Medicaid’s website at www.medicaid.alabama.gov by clicking on the Providers tab then
selecting Fee Schedules.
As a reminder, providers must
deliver services within their scope of practice, and have the proper
certification and licensure to perform these tests.
During the COVID-19 emergency, it
is important to file claims as quickly as possible to ensure payment from
Medicaid is made to Medicaid providers close to the date of service. The
Centers for Medicare and Medicaid Services (CMS) has increased the federal
matching percentage for the emergency time frame, but states can only receive
the increased match on claims that are paid during the emergency.
For questions, please visit the
Medicaid website at www.medicaid.alabama.gov,
or call the Medicaid Fiscal Agent at 1-800-688-7989.
Contacts:
solomon.williams@medicaid.alabama.gov,
susan.watkins@medicaid.alabama.gov,
or beverly.churchwell@medicaid.alabama.gov
The Current Procedural Terminology (CPT) and Current Dental Terminology
(CDT) codes descriptors, and other data are copyright © 2020
American Medical Association and © 2020 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.