HCPCS Code U0002: 2019-nCoV Coronavirus, COVID-19, Any Technique, Non-CDC Laboratory Test

HCPCS U0002 covers billing for non-CDC COVID-19 diagnostic tests, helping providers, patients, and labs with CMS guidance, coverage, and payment.

Use Code

## **What is HCPCS U0002?** HCPCS Code U0002 is used for billing laboratory diagnostic tests for detecting the 2019 novel coronavirus (SARS-CoV-2 or COVID-19) when the test is performed using non-CDC laboratory tests developed outside CDC testing laboratories. It applies to any technique and includes multiple types or subtypes (all targets) of the virus. This HCPCS code enables laboratories and healthcare providers to bill for COVID-19 diagnostic tests that are not developed by the CDC, distinguishing it from HCPCS Code U0001, which is specifically for tests developed by the CDC. The code became effective for dates of service on or after February 4, 2020. Medicare’s national payment rate for U0002 is currently about $51.31, although actual reimbursement may vary by Medicare Administrative Contractor (MAC), Medicaid program, or commercial payer. Claims from CLIA-waived laboratories must include the QW modifier to indicate that the test was performed in a CLIA-certified setting. These requirements support accurate reporting, proper claims adjudication, and coverage under Medicare, Medicaid, and private insurance.

## **HCPCS Code U0002 documentation requirements** To ensure proper reimbursement and compliance, providers and laboratories must maintain documentation that supports the use of HCPCS Code U0002 for non-CDC COVID-19 tests. ### **Patient and order details** Documentation must include the patient’s identifying information, the ordering physician or other qualified provider, the date of service, and the specimen source collected for SARS-CoV-2 testing. ### **Test type and result** Records should clearly indicate that a non-CDC developed diagnostic test was performed and the result (positive, negative, or inconclusive). U0002 should not be used for CDC tests, which are reported under U0001. ### **Reason for testing** Clinical notes or the test order should state the reason for testing, such as suspected infection, exposure screening, or other protocol-driven requirement, consistent with payer policy. ### **Record retention** Maintain documentation in accordance with CMS and payer record retention policies to support audit readiness. This includes keeping internal records of test validation and compliance with FDA Emergency Use Authorization (EUA) or other approval status when applicable.

## **HCPCS Code U0002 billing requirements** HCPCS Code U0002 is used by laboratories and healthcare providers to bill Medicare, Medicaid, and commercial payers for validated, non-CDC COVID-19 diagnostic tests. ### **Effective date** Claims using U0002 are valid for dates of service on or after February 4, 2020, the effective date established by CMS for this code. ### **CLIA and QW modifier** When testing is performed in a CLIA-waived laboratory, the claim must include the QW modifier and the lab’s CLIA number. This requirement applies to dates of service on or after March 20, 2020. ### **Payment rates** Medicare’s national payment rate for U0002 is approximately $51.31. Payment amounts may vary slightly by Medicare Administrative Contractor (MAC) and can differ under Medicaid or commercial payer policies. ### **Claim details** Claims must include the patient’s demographic information, ordering provider, diagnosis code (e.g., Z20.822 for exposure to COVID-19 or appropriate ICD-10-CM symptom code), specimen collection date, and result information. ### **Coverage considerations** Coverage and cost-sharing rules can vary by payer and have changed over time (especially before and after the COVID-19 Public Health Emergency). Providers should verify payer-specific policies to confirm coverage and patient responsibility.

## **Other relevant codes** - **HCPCS U0001**: For CDC-developed tests only (2019-nCoV Real-Time RT-PCR Diagnostic Panel)