News: Hospitals set prices ranging from $20 to $1,419 for COVID-19 tests

CDI Strategies - Volume 16, Issue 2

A recent analysis by Peterson-KFF Health System Tracker found that hospital-set prices for COVID-19 tests ranged greatly from as low at $20 to as high as $ 1,419. While the Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security Act (CARES Act) ensure that most health plans must cover COVID-19 testing with no cost sharing, no federal laws have been created to regulate the price of diagnostic testing outside of Medicare.

Because the CARES Act price transparency rule requires hospitals to make the pricing of selected tests and procedures readily available on their website, Peterson-KFF Health System Tracker was able to find COVID-19 diagnostic test prices for 93 out of 102 hospitals in the analysis.

The analysis found the cost of single COVID-19 diagnostic tests to range from $20 to $1,419, not including the price of a provider visit, facility fee, or specimen collection. The median cost of a COVID-19 diagnostic test was $148. Just under half of the test charges (47%) were priced between $100 and $199, and 20% were priced above $300. Medicare reimburses “providers between $36 to $143 per diagnostic test, depending on the type of test and how quickly the test is processed.” In terms of private-payer negotiated prices, the analysis says it “observed a broad range of COVID-19 testing prices, even within the same hospital system.”

Editor’s note: The Peterson-KFF Health System Tracker analysis can be found here. Additional ACDIS coverage of the price transparency ruling can be found here.

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