At this time Blue Cross Blue Shield (BCBS) and United Healthcare (UHC) are paying less than other medical insurance payors and less than our expense for performing the test. These patients may go to an urgent care or county health department or purchase an over the counter rapid test and self test. Alternatively, a PCR test can be performed at no additional cost by our office. The cash pay price of the test is $75, if you have blue cross blue shield or united healthcare and prefer for our office to perform the rapid test.
Per section 3202 of CARES Act
SEC. 3202. PRICING OF DIAGNOSTIC TESTING.
(a) REIMBURSEMENT RATES.—A group health plan or a health
insurance issuer providing coverage of items and services described
in section 6001(a) of division F of the Families First Coronavirus
Response Act (Public Law 116–127) with respect to an enrollee
shall reimburse the provider of the diagnostic testing as follows:
(1) If the health plan or issuer has a negotiated rate with
such provider in effect before the public health emergency
declared under section 319 of the Public Health Service Act
(42 U.S.C. 247d), such negotiated rate shall apply throughout
the period of such declaration.
(2) If the health plan or issuer does not have a negotiated
rate with such provider, such plan or issuer shall reimburse
the provider in an amount that equals the cash price for such
service as listed by the provider on a public internet website,
or such plan or issuer may negotiate a rate with such provider
for less than such cash price.
(b) REQUIREMENT TO PUBLICIZE CASH PRICE FOR DIAGNOSTIC
TESTING FOR COVID–19.—
(1) IN GENERAL.—During the emergency period declared
under section 319 of the Public Health Service Act (42 U.S.C.
247d), each provider of a diagnostic test for COVID–19 shall
make public the cash price for such test on a public internet
website of such provider.
OUR BILLED CASH PRICE FOR RAPID COVID 19 testing is $75. Other urgent care facilities in our area charge $100 or more.