CommercialReimbursementHigh impact
COVID-19 Laboratory Tests Reimbursement Changes for Urgent Care Centers and Convenience Care Clinics
Florida Blue·FL · Emergency Medicine, Family Medicine, General Practice +1 more·Claims & Billing
Effective date
Oct 1, 2026
We identified it
Jul 9, 2026
Summary
Effective October 1, 2026, Florida Blue will no longer provide separate reimbursement for COVID-19 laboratory tests performed at Urgent Care Centers (UCC) and Convenience Care Clinics (CCC). COVID-19 lab testing reimbursement will be bundled into the standard urgent care service fee, similar to flu and strep tests. Billing teams must stop billing 15 specific COVID-19 lab procedure codes for separate reimbursement at these locations.
Action Required
By September 30, 2026: Billing team must update billing software and fee schedules to stop billing the 27 listed COVID-19 laboratory procedure codes (0202U, 0223U-0226U, 86328, 86769, 86408-86409, 87426, 87428, 87635-87637, 87811, 87913, 90480, J0248, M0224, M0249-M0250, Q0224, U0001-U0005) for separate reimbursement when performed at Urgent Care Centers and Convenience Care Clinics billing to Florida Blue plans. Update claim editing rules to bundle COVID-19 lab tests into the standard urgent care service code instead. Notify UCC and CCC providers of this change so they understand COVID-19 testing remains covered but will not generate separate line items. Failure to implement this change will result in claim denials and payment recoupment after October 1, 2026.