PHE Expiration: COVID Testing Reimbursement

Date: 05/08/23

In accordance with the expiration of the Public Health Emergency (PHE) effective 5/11/2023, Covid testing will no longer be required to be reimbursed at 100% of the Medicare allowable.  As such, Ambetter’s Payor Fee Schedule methodology will classify Covid testing in accordance with other laboratory testing and reimburse at the 50% of Medicare laboratory benchmark rate.

We thank you for your commitment to the care and wellbeing of our members and to the communities we serve.  Should you have any questions or concerns about this notification, please contact us at Provider Services 1-844-606-1926.