Diagnostics, Policy

CMS to pay less for Covid-19 test results that take longer than two days

Starting in January, Medicare will pay $75 for tests that take longer than two days to deliver results. It currently pays $100 for each high-throughput Covid-19 test.

A change in how Medicare pays for Covid-19 diagnostic tests would penalize laboratories that take more than two days to process them. On Thursday, the Centers for Medicare and Medicaid Services announced that it would only pay laboratories the full $100 for each high-throughput Covid-19 test if they processed it within two days of the specimen being collected.

Starting in January, for tests that take longer than two days to process, Medicare will only pay $75.

LabCorp, which has processed millions of Covid-19 tests and claims a one-day turnaround time, did not comment on the reimbursement changes. Instead it pointed to a statement from The American Clinical Laboratory Association (ACLA), a trade group representing laboratories.

“Cutting laboratory reimbursement won’t address the root causes of delayed turnaround times,” ACLA stated. “Turnaround time is driven largely by fluctuations in demand and access to critical supplies. As states across the country experience a surge in new cases, the global demand for testing supplies remains high.”

Quest Diagnostics, another big provider of coronavirus tests, also deferred to the ACLA statement. The company said on average, its tests are processed within two days.

Though testing capacity has improved since the initial months of the pandemic, many states still have faced shortages. A recent survey of more than 52,000 people across the U.S. found that average testing times have fallen from four days in April to 2.7 days in September. Getting a result quickly is important, because after two days, it becomes difficult to contact trace.

The survey, conducted by researchers at Northeastern, Harvard, Rutgers and Northwestern Universities, found that people had difficulty accessing testing during the most recent Covid-19 wave in September. Roughly 8% of respondents during that time said they wanted to get a test, but were unable to get one. Of that group, 29% said they were told by medical professionals that they did not need a test, and 31% did not know how or where to get a test.

“Despite decreased average wait times, a substantial proportion of Americans still endure long waits,” researchers wrote.  “In September, 42% of those tested had to wait at least 3 days before getting their results; the corresponding percentage in April was 56%.”

Researchers also noted disparities in how long it took to get test results between March and September. Black respondents had to wait almost an entire day longer than white respondents to get their test results, an average of 4.4 days compared to 3.5 days.

Another important finding: Contact tracing still seems to be lagging across the U.S. Only 56% of respondents who received a positive Covid-19 test said they were contacted for contact tracing.

Photo credit: David Hecker, Getty Images

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