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Florida BlueCommercial · Reimbursement · Claims & Billing · FL · Emergency Medicine, Family Medicine, General Practice +1 moreHigh impact

COVID-19 Laboratory Tests Reimbursement Changes for Urgent Care Centers and Convenience Care Clinics

Act
by Sep 30, 2026
Effective date
Oct 1, 2026
Identified
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.

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What to do

by Sep 30, 2026 · 3 steps
01Billing 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.
02Update claim editing rules to bundle COVID-19 lab tests into the standard urgent care service code instead.
03Notify UCC and CCC providers of this change so they understand COVID-19 testing remains covered but will not generate separate line items.
If missed: Failure to implement this change will result in claim denials and payment recoupment after October 1, 2026.

Codes mentioned

863288676986408864098742687428876358763687637878118791390480J0248M0224M0249M0250Q0224U0001U0002U0003U0004U0005

Original notice

COVID-19 Laboratory Tests Reimbursement Changes for Urgent Care Centers and Convenience Care Clinics
files.guidewell.com · Always check the source before changing claims.
View original ↗

Related policy hubs

Florida Blue policiesFL policy changesEmergency MedicineFamily MedicineGeneral PracticeInfectious DiseaseCode 86328Code 86769Code 86408Code 86409Code 87426Code 87428Code 87635Code 87636Code 87637Code 87811Code 87913Code 90480Code J0248Code M0224Code M0249Code M0250Code Q0224Code U0001Code U0002Code U0003Code U0004Code U0005

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