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MedicaidBilling CodesMedium impact

COVID-19: COVID Testing and Specimen Collection Codes

Missouri Medicaid (MO HealthNet)·MO · Family Medicine, Internal Medicine, General Practice·Provider Notice
Effective date
Mar 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

MO HealthNet updated COVID-19 testing and specimen collection billing codes, rates, and coverage rules. Key changes include rate reductions for high throughput testing codes U0003/U0004 (from $100 to $75) effective January 1, 2021, and updated billing requirements for independent laboratories and pharmacies.

Action Required

Action needed
Immediately: Update billing system with current COVID-19 testing code rates, especially reduced rates for U0003/U0004 ($75 vs previous $100). Ensure independent lab claims for COVID-19 testing are submitted on separate claims from other lab services. Verify pharmacists can bill COVID-19 testing codes for dates of service after January 1, 2021. Claims not following these requirements will be recycled or denied.

Affected Billing Codes

U0001
U0002
87635
86328
86769
87426
86408
86409
86413
87636
87637
87811
87428
U0003
U0004
U0005
99211
C9803
G2023
G2024