Specified COVID–19 testing-related services
For purposes of subsection (a)(1)(DD):
(1) Description
(1)Description#
(A) In general A specified COVID–19 testing-related service described in this paragraph is a medical visit that— (i) is in any of the categories of HCPCS evaluation and management service codes described in subparagraph (B); (ii) is furnished during any portion of the emergency period (as defined in section 1320b–5(g)(1)(B) of this title ) (beginning on or after March 18, 2020 ); (iii) results in an order for or administration of a clinical diagnostic laboratory test described in section 1395w–22(a)(1)(B)(iv)(IV) of this title ; and (iv) relates to the furnishing or administration of such test or to the evaluation of such individual for purposes of determining the need of such individual for such test.
(B) Categories of HCPCS codes For purposes of subparagraph (A), the categories of HCPCS evaluation and management services codes are the following: (i) Office and other outpatient services. (ii) Hospital observation services. (iii) Emergency department services. (iv) Nursing facility services. (v) Domiciliary, rest home, or custodial care services. (vi) Home services. (vii) Online digital evaluation and management services.
(1)(A)In general#
A specified COVID–19 testing-related service described in this paragraph is a medical visit that—
(i) is in any of the categories of HCPCS evaluation and management service codes described in subparagraph (B);
(ii) is furnished during any portion of the emergency period (as defined in section 1320b–5(g)(1)(B) of this title ) (beginning on or after March 18, 2020 );
(iii) results in an order for or administration of a clinical diagnostic laboratory test described in section 1395w–22(a)(1)(B)(iv)(IV) of this title ; and
(iv) relates to the furnishing or administration of such test or to the evaluation of such individual for purposes of determining the need of such individual for such test.
(2)Specified outpatient payment provision#
A specified outpatient payment provision described in this paragraph is any of the following:
(A) The hospital outpatient prospective payment system under subsection (t).
(B) The physician fee schedule under section 1395w–4 of this title .
(C) The prospective payment system developed under section 1395m( o ) of this title.
(D) Section 1395m(g) of this title , with respect to an outpatient critical access hospital service.
(E) The payment basis determined in regulations pursuant to subsection (a)(3) for rural health clinic services.
(2)(A)#
The hospital outpatient prospective payment system under subsection (t).
(2)(B)#
The physician fee schedule under section 1395w–4 of this title .
(2)(C)#
The prospective payment system developed under section 1395m( o ) of this title.