Increase Reimbursement Rates for COVID-19 Multiplex Tests
Please contact the Centers for Medicare & Medicaid Services (CMS) to request an increase in reimbursement so patients, physicians, and APPs can have greater access to a combined flu and COVID-19 test.
I have tested and treated a record number of patients for the past two years, throughout the COVID-19 pandemic. Having access to the most efficient tests during this year's respiratory infection season will be crucial to reduce the spread of illness and ensure that patients receive the best possible care and treatment.
Currently, the Medicare payment rate for point-of-care tests that provide three results, aka “multiplex tests” (Influenza A and B, and SARS-CoV-2), is inexplicably lower than the payment rate for a COVID-only point-of-care test. As a result of the lower reimbursement rate, to cover our costs, Urgent Care centers must run one test at a time (flu and COVID tests separately) rather than using a multiplex test.
During a busy flu season this results in a longer workflow for Urgent Care centers and, more importantly, an inefficient use of a patient's time spent in the office. To the extent that clinicians administer one test (e.g., for COVID), obtain a negative result, and require patients to wait in office or return for another test (e.g., for Influenza), patients may experience delays in treatment and continue to infect others.
The proposed CY 2023 payment rate discourages use of combined diagnostic tests by not reflecting the resources required to run these tests. This is the second year in a row that CMS has decided to ignore the majority vote of their Clinical Diagnostic Laboratory Tests (CDLT) Advisory Panel.
We believe CMS would greatly benefit from hearing from Senators about the value to patients and providers for a combined COVID and flu test. Please contact CMS immediately to support this increase in reimbursement for multiplex tests!
Thank you!
Increase Reimbursement Rates for COVID-19 Multiplex Tests
Please contact the Centers for Medicare & Medicaid Services (CMS) to request an increase in reimbursement so patients, physicians, and APPs can have greater access to a combined flu and COVID-19 test.
I have tested and treated a record number of patients for the past two years, throughout the COVID-19 pandemic. Having access to the most efficient tests during this year's respiratory infection season will be crucial to reduce the spread of illness and ensure that patients receive the best possible care and treatment.
Currently, the Medicare payment rate for point-of-care tests that provide three results, aka “multiplex tests” (Influenza A and B, and SARS-CoV-2), is inexplicably lower than the payment rate for a COVID-only point-of-care test. As a result of the lower reimbursement rate, to cover our costs, Urgent Care centers must run one test at a time (flu and COVID tests separately) rather than using a multiplex test.
During a busy flu season this results in a longer workflow for Urgent Care centers and, more importantly, an inefficient use of a patient's time spent in the office. To the extent that clinicians administer one test (e.g., for COVID), obtain a negative result, and require patients to wait in office or return for another test (e.g., for Influenza), patients may experience delays in treatment and continue to infect others.
The proposed CY 2023 payment rate discourages use of combined diagnostic tests by not reflecting the resources required to run these tests. This is the second year in a row that CMS has decided to ignore the majority vote of their Clinical Diagnostic Laboratory Tests (CDLT) Advisory Panel.
We believe CMS would greatly benefit from hearing from Senators about the value to patients and providers for a combined COVID and flu test. Please contact CMS immediately to support this increase in reimbursement for multiplex tests!
Thank you!