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CAP Calls on Medicare to Cease Implementation of Payment Cuts for COVID-19 Tests

WASHINGTON–()–The College of American Pathologists (CAP) strongly objected to Medicare cuts to fees for certain COVID-19 tests, which the Centers for Medicare & Medicaid Services (CMS) announced late yesterday. In a statement by CAP President Patrick Godbey, MD, FCAP, the largest association of board-certified pathologists called on the administration to cease implementation of a payment structure that will cut fees for COVID-19 testing performed on a high throughput technology platform and penalize laboratories in the middle of a global pandemic.

“Every pathologist and the laboratory that he or she leads strives to provide patients with high-quality testing and fast results—especially during this pandemic,” Dr. Godbey said. “With roughly one million COVID-19 tests being provided every day, laboratories are processing tests efficiently and quickly in most instances. However, there are several factors outside of our control that lead to delays. These factors include the delivery times of off-site specimen collection and the availability of testing supplies needed to run tests. The CMS’ new pricing scheme does absolutely nothing to solve these problems but will penalize laboratories and create a new administrative burden during the billing process.

“The CAP urges the CMS to cease implementation of this misguided fee structure and answer our repeated calls to take steps to support pathologists and laboratories by increasing Medicare rates for COVID-19 tests.”

On October 15, the CMS said it would cut the price for high-throughput COVID-19 tests by 25%, reducing the fee to $75 from $100, beginning January 1, 2021. Medicare will also adopt an add-on payment of $25 for tests run on the high-throughput platform if the laboratory completes the test in two calendar days or less, and if the majority of its testing using the high-throughput technologies is done in two calendar days or less for all patients (not just Medicare beneficiaries) in the previous month. This cut will take effect despite the fact that current fees are already inadequate in many parts of the country.

For non-high throughput COVID-19 laboratory tests, local Medicare Administrative Contractors remain responsible for developing the payment amount in their respective jurisdictions. Medicare contractors are currently paying approximately $51 for those tests. The CMS earlier defined a high-throughput technology as a platform that employs automated processing of more than two hundred specimens a day. Examples of high-throughput systems include technologies the Roche cobas 6800 System, Roche cobas 8800 System, Abbott m2000 System, Hologic Panther Fusion System, GeneXpert Infinity System, and NeuMoDx 288 Molecular.

About the College of American Pathologists

As the world’s largest organization of board-certified pathologists and leading provider of laboratory accreditation and proficiency testing programs, the College of American Pathologists (CAP) serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. As a 501(c)(6) membership organization, the CAP is the only entity representing pathologists with unrestricted advocacy capability and a political action committee, PathPAC. For more information, visit to watch pathologists at work and see the stories of the patients who trust them with their care. Read the CAP Annual Report.

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