U0005 Insurance Policy Changes

HCPCS U0005 is officially defined as "Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2." HCPCS U0005 is referenced in 3 tracked payer policy changes from Florida Blue, Oregon Health Plan, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS U0005 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.