Wiki Covid Test and Medicaid Denials

Lorisvg

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Is anyone else getting denials for 87426 for all Medicaid plans saying this is a non covered service. We have learned the problem is that the payment amount is not on the Medicare fee schedule, although Medicare is paying it. We are sitting with a bunch of denials, and it is still not on the 2021 fee schedule. Is anyone else having this problem, and what did you do about it?
 
I work for urgent care clinic. Our providers are considering doing rapid testing as well, I emailed one of local insurance rep for reimbursement information and the rep wants to know if we are referring to administration of the test, or the processing of the specimen of the test. I am a little confused with her question.
 
I work for urgent care clinic. Our providers are considering doing rapid testing as well, I emailed one of local insurance rep for reimbursement information and the rep wants to know if we are referring to administration of the test, or the processing of the specimen of the test. I am a little confused with her question.
I think she is asking if you are talking about a charge for taking the test (we do a 99211 when the pt is only having the test, not being seen) or if you are asking about running the test.
 
Is anyone else getting denials for 87426 for all Medicaid plans saying this is a non covered service. We have learned the problem is that the payment amount is not on the Medicare fee schedule, although Medicare is paying it. We are sitting with a bunch of denials, and it is still not on the 2021 fee schedule. Is anyone else having this problem, and what did you do about it?
YES!!!!! I am receiving denials for all of my 87426 !!!! (this is SC DHHS denial EDIT 171) I have no clue what to do !!!
 
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