Health care providers who have conducted COVID-19 testing or provided treatment for uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020 will be eligible to seek reimbursement for COVID-19 testing and testing-related visits for uninsured individuals, as well as treatment for uninsured individuals with a COVID-19 diagnosis.
With a portion of funding from the CARES Act, The U.S. Department of Health and Human Services (HHS) will provide claims reimbursement to physicians and other healthcare providers for COVID-19 treatment of uninsured individuals. Under the Families First Coronavirus Response Act, HHS will provide claims reimbursed to providers for testing of uninsured individuals.
To Participate in the Program, Providers Must:
- Confirm the Patient is Uninsured. Check for health care coverage eligibility and confirm that the patient is uninsured. Verify that the patient does not have coverage through an individual, or employer-sponsored plan, a federal healthcare program, or the Federal Employees Health Benefits Program at the time services were rendered, and no other payer will reimburse you for COVID-19 testing and/or care for that patient.
- Agree to Not Balance Bill the Patient.
- Accept defined program reimbursement as payment in full.
- Agree to program terms and conditions. Providers may be subject to post-reimbursement audit review.
How It Works
Health care providers who have conducted COVID-19 testing or provided treatment for uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020, can electronically request claims reimbursement through the program and will be reimbursed generally at Medicare rates, subject to available funding. Steps will involve: enrolling as a provider participant, checking patient eligibility, submitting patient information, submitting claims electronically, and receiving payment via direct deposit.
Get started by visiting the official website for the HRSA COVID-19 Uninsured Program.
The Program Timeline
- April 22: Program Details launch
- April 27: Sign up period begins for the program
- April 29: On Demand training starts
- May 6: Begin submitting claims electronically
- May 18: Begin receiving reimbursement
What is Covered?
- Specimen collection, diagnostic and antibody testing.
- Testing-related visits including in the following settings: office, urgent care or emergency room or telehealth.
- Treatment, including office visit (including telehealth), emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care (LTAC), acute inpatient rehab, home health, DME (e.g., oxygen, ventilator), emergency ambulance transportation, non-emergent patient transfers via ambulance, and FDA approved drugs as they become available for COVID-19 treatment and administered as part of an inpatient stay.
- FDA-approved vaccine, when available.
Claims will be subject to Medicare timely filing requirements.
Services not covered by traditional Medicare will also not be covered under this program. In addition, the following services are excluded:
- Any treatment without a COVID-19 primary diagnosis, except for pregnancy when the COVID-19 code may be listed as secondary.
- Hospice services.
- Outpatient prescription drugs.
Claims Reimbursement
- Claims reimbursement will be based on current year Medicare fee schedule rates except where otherwise noted.
- Reimbursement will be based on incurred date of service.
Questions?
- HRSA COVID-19 Uninsured Program website https://coviduninsuredclaim.linkhealth.com
- COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing and Treatment of the Uninsured https://www.hrsa.gov/CovidUninsuredClaim
