Only give patients OTC COVID-19 tests when they request them, and inform patients (or their caregivers) that Medicare doesn’t cover or pay for these tests. But, starting on May 12, 2023, Medicare won’t cover or pay for OTC COVID-19 tests for Medicare Part B patients. Medicare only paid for OTC COVID-19 tests during this demonstration, which ended after May 11, 2023.Īfter May 11, 2023, you can continue to sell OTC COVID-19 tests to patients, including those enrolled in Part B or MA plans. This is because Part B covers a variety of outpatient services, including medically necessary clinical diagnostic laboratory tests, but doesn’t cover or pay for OTC services and tests. Eligible patients will continue to get these lab-conducted tests at no cost, and their annual deductible, coinsurance, and copayment doesn’t apply. Medicare patients with Part B benefits still have access to laboratory-conducted COVID-19 tests (like PCR tests), even after the COVID-19 PHE ends. MA plan enrollees should check with their MA plan to see if it covers and pays for these tests. Some Medicare Advantage (MA) plans may cover and pay for OTC COVID-19 tests as an added benefit. Starting on May 12, 2023, Medicare no longer covers or pays for OTC COVID-19 tests for those with Medicare Part B benefits. The OTC COVID-19 test demonstration ended on May 11, 2023. If you’re a person with Medicare Part B, learn more about the end of coverage of OTC COVID-19 tests after. Review this page for information about Medicare coverage of over-the-counter (OTC) COVID-19 tests that was in place during the PHE and the ending of this coverage after the PHE. This webpage is for health care providers. View Infectious diseases for a list of waivers and flexibilities that were in place during the PHE. The COVID-19 public health emergency (PHE) ended at the end of the day on May 11, 2023. Medicare Provider Cost Report Public Use Files.Provider statistical & reimbursement report.Medicare fee for service for Parts A & B.Medicare Claims Synthetic Public Use Files (SynPUFs).Health Care Information System (HCIS) data file.Medicare Provider Utilization and Payment Data.Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files for Download.Next Generation ACO Model (NGACO) Public Use Files.Medicare Advantage/Part D Contract and Enrollment Data.Comprehensive End Stage Renal Disease (ESRD) Care (CEC) Model Public Use Files.
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