MedicaidBilling CodesHigh impact
UPDATE-COVID-19 Reimbursable Laboratory Codes
Maryland Medicaid·MD · Pathology, Infectious Disease, Emergency Medicine·Provider Transmittal
Effective date
Jun 25, 2020
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is adding 10 new reimbursable COVID-19 laboratory codes effective June 25, 2020, including molecular tests, antigen detection, antibody tests, and multiplex respiratory panels. The billing team must update systems to recognize these codes and apply the specified FFS reimbursement rates ranging from $23.46 to $416.78. Two specimen collection codes (G2023, G2024) are also reimbursable for independent laboratories collecting specimens from homebound or non-hospital inpatient individuals.
Action Required
By June 25, 2020: Billing team must update billing system fee schedules with all 12 codes and their FFS reimbursement rates. Update billing software to recognize codes U0001, U0002, U0003, U0004, 87635, 87426, 86328, 86769, 0223U, 0224U, G2023, and G2024. For codes U0003 and U0004, configure system logic to identify high-throughput tests and prevent bundling with antibody detection codes. Implement edit to prevent simultaneous billing of 0224U with 86769. Train billing staff on specimen collection eligibility rules: G2023 and G2024 are only reimbursable when trained laboratory personnel collect specimens from homebound individuals or non-hospital inpatients—NOT for messenger pickup or patient self-collection. Communicate policy to laboratory directors and testing coordinators. Failure to implement correct codes and rates will result in claim rejections or underpayment.