MedicaidBilling CodesHigh impact
UPDATE - COVID-19 Reimbursable Laboratory Codes
Maryland Medicaid·MD · Pathology, Infectious Disease, Emergency Medicine +4 more·Provider Transmittal
Effective date
Oct 6, 2020
We identified it
Jun 20, 2026
Summary
Maryland Medicaid (FFS) is adding 11 new reimbursable COVID-19 laboratory codes (0202U, 0225U, 0226U, 86408, 86409, 86413, 87636, 87637, 87811, 0240U, 0241U) effective October 6, 2020, with reimbursement at 100% of Medicare rates. These codes are classified as self-referred services and qualify for billing under Maryland's Managed Care Organizations and FFS programs.
Action Required
By December 2020: Billing team must immediately update billing system to include all 11 newly reimbursable COVID-19 laboratory codes (0202U, 0225U, 0226U, 86408, 86409, 86413, 87636, 87637, 87811, 0240U, 0241U) with their corresponding FFS reimbursement rates ranging from $41.38-$142.63. Configure these codes as self-referred services for Maryland Medicaid claims. Ensure all laboratory and provider staff are notified of this update. Update internal fee schedules and claim submission templates to reflect the new codes. When billing U0003 or U0004, ensure billing staff verify these codes identify high-throughput tests and do not bill for antibody detection. For specimen collection, configure billing system to allow G2023 ($23.46) for homebound/non-hospital inpatient collection and G2024 ($25.46) for SNF or HHA collection. Failure to update coding will result in claim denials and lost reimbursement for COVID-19 testing services.