This article was revised on July 16, 2021, to update the coverage effective dates and simplify the format. To learn about treatment for COVID-19, please read this article. To learn about billing and coding for COVID-19 testing, please read this article.
Member coverage for COVID-19 testing
Independence will cover and waive member cost-sharing (i.e., copayment, deductible, and coinsurance) for COVID-19 tests performed at physician offices, urgent care centers, emergency rooms, drive-through testing sites, pharmacies, and by home health agencies when ordered or authorized by a health care professional licensed and/or qualified to do so under state law as outlined below. Testing coverage for Commercial, Medicare Supplement, and Keystone CHIP members is effective March 6, 2020, through the later of either October 31, 2021, or the duration of the public health emergency. Testing coverage for Medicare Advantage members is through 2021.
Fees related to furnishing or administration of COVID-19 testing
There is no cost-sharing whether in network or out of network for fees related to the administration of the test rather than treatment for COVID-19.
Facility fees must be covered without cost-sharing whether in network or out of network to the extent the fees relate to the furnishing or administration of the test or evaluating for the need for the test.
Coverage criteria and requirements
Read the policy News Article, Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)), for more detailed information on coverage criteria and other requirements:
- Specimen collection administered by health care professionals and processed at an approved lab
- Diagnostic RT-PCR and antigen tests and antibody tests
- Differential diagnosis
- Specimen collection by an authorized worker from a home health agency
- Specimen collection by members
- Home test kits
- At-home self-sample collection
- Routine testing
- In advance of procedures
- Testing of nursing home residents and patients
- Public health surveillance and screening
Working with LabCorp
Laboratory Corporation of America® Holdings (LabCorp), the exclusive national outpatient laboratory provider for Independence, is equipped to perform diagnostic and antibody testing for COVID-19 for all Independence members, even those who are not capitated to LabCorp.
- The LabCorp diagnostic RT-PCR and antibody (IgG) tests are available to all offices – hospitals, urgent care centers, and physician offices. Please follow the Centers for Disease Control and Prevention guidelines for ordering the tests. When ordering tests through LabCorp, use code 139900 for diagnostic tests and code 164055 for antibody tests.
- LabCorp will not obtain COVID-19 specimens at their patient service centers (PSC). Any person trying to get a COVID-19 test at a LabCorp PSC will be referred to their physician.
- LabCorp will collect antibody blood tests at their PSCs. Any person trying to get an antibody test must first place an order through a physician.
The antibody test is only available for persons ages 18 or older.
For more information on sending test specimens and/or receiving testing supplies visit LabCorp's website.
Note: The Supply Order form can be faxed or emailed. Both swabs and Universal Transport Media (UTM) can be ordered using this form. The UTM is on the form and the swab can be written in as the Nasopharyngeal or Oropharyngeal Swab.
A LabCorp account is needed to order tests. If you need to set up an account with LabCorp, visit NENewaccounts@labcorp.com or call 1-888-295-5915.
Independence is committed to providing our members with access to the care they need during the COVID-19 pandemic. We encourage all Independence members and providers to visit our dedicated COVID-19 webpage regularly for the latest news and updates. We will continue to evaluate member needs as the situation changes.
Please review the policy News Article,
Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)), for more detailed information. You can view this article on our Medical and Claim Payment Policy Portal in the News & Announcements section:
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