Question Reimbursement for 87426

[melgulledge]

Could anyone share their reimbursement for the rapid covid test code 87426???
Thanks!!

 

[Fustilugs3]

I really, really wish someone would reply to questions like this. I'm trying to establish what price to bill, but it is starting to seem impossible to find reimbursement rates for this code from ANY payer. So frustrating!

 

[VALJONES5959]

Hi,
If the code is on the Medicare fee schedule, you can multiply that fee times 3 to have an idea of what amount to bill.

 

[trarut]

I suspect most of us don't reply because your offices should have a fee schedule policy that outlines how to set new fees (i.e. what it's based off of, what multiplier to use, etc.). This answer is very specific to the practice and there is no one set answer. New fees have always been set by the Revenue Cycle Manager at all of my previous employers; coding was not involved beyond providing the new codes and their effective dates.

Having said that, I agree with VALJONES5959 - I think it's fairly common to use 300% of Medicare's fee schedule as a standard when setting new fees.

 

[SueLis]

Blue Cross Blue Shield of Michigan is paying $35.00 for 87426