Medicare Coverage of COVID-19 Testing for Nursing Home Residents and Patients

CMS has instructed MACs and notified Medicare Advantage plans to cover COVID-19 lab tests for nursing home residents and patients. This instruction follows the CDC’s recent update of COVID-19 testing guidelines for nursing homes that provides recommendations for testing of nursing home residents and patients with symptoms consistent with COVID-19 as well as for asymptomatic residents and patients who have been exposed to COVID. Original Medicare and Medicare Advantage plans will cover COVID-19 lab tests consistent with CDC guidance.

Medicare Advantage plans must continue not to charge cost sharing (including deductibles, copayments, and coinsurance) or apply prior authorization or other utilization management requirements for COVID-19 tests and testing-related services.

Click here to read the Medicare Learning Network article, which other updates to COVID-19 waivers and flexibilities.

Click here to learn more about Medicare’s coverage of COVID-19 tests.

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