Correct Coding Updates for COVID-19 Specimen Collection

CarePartners of Connecticut is updating our Laboratory and Pathology Payment Policy to reflect correct coding related to specimen collection for COVID-19 testing. As a result, effective for dates of service beginning Sept. 1, 2022, the following billing and reimbursement practices will apply.

HCPCS codes G2023 or G2024 for COVID-19 specimen collection will only be reimbursed when billed by an independent clinical laboratory, and HCPCS code C9803 should be reported when COVID-19 specimen collection occurs during a hospital outpatient clinic visit.

CPT code 99211 should only be billed when a specimen collection is the only service rendered by clinical staff during a physician office visit. If the specimen collection is performed as part of another service or procedure, such as a higher-level visit furnished by the billing practitioner, that higher-level visit code should be billed and the specimen collection would not be separately payable.

Please keep in mind that G2023/G2024 or C9803 should only be used when the provider or facility is not running the test. If the provider or facility is running the test, the appropriate test code should be billed, not the specimen collection code. Modifier CR or CS should be appended, as appropriate, to a COVID-19 testing/specimen collection code and any related E/M code on professional and outpatient facility claims.

For more information, please refer to the updated Laboratory and Pathology Payment Policy and CarePartners of Connecticut’s COVID-19 Vaccine and Testing Codes grid.