August 20, 2020

State of Alabama
Press Release: Medicaid

COVID-19 Rapid Test Procedure Code 87426

PDF Version

TO:  Physicians, FQHCs, RHCs, Independent Labs, Hospitals, and ADPH


As Medicaid continues to monitor the COVID-19 emergency in Alabama, the Agency is adding the testing procedure for coverage below:

 

  • 87426 - Infectious agent antigen detection by immunoassay technique, (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19])
  • Note: Providers with a valid CLIA certificate of waiver indicator may bill procedure 87426 with modifier QW.

Providers may begin submitting claims on August 24, 2020 for dates of service on or after June 25, 2020.

Reimbursement rates for the COVID-19 testing and specimen collection procedure codes can be found on Medicaid’s website at www.medicaid.alabama.gov by clicking on the Providers tab then selecting Fee Schedules.

 

As a reminder, providers must deliver services within their scope of practice, and have the proper certification and licensure to perform these tests.

 

During the COVID-19 emergency, it is important to file claims as quickly as possible to ensure payment from Medicaid is made to Medicaid providers close to the date of service. The Centers for Medicare and Medicaid Services (CMS) has increased the federal matching percentage for the emergency time frame, but states can only receive the increased match on claims that are paid during the emergency.

 

For questions, please visit the Medicaid website at www.medicaid.alabama.gov, or call the Medicaid Fiscal Agent at 1-800-688-7989.

Contacts:

solomon.williams@medicaid.alabama.gov
,
susan.watkins@medicaid.alabama.gov
, or
beverly.churchwell@medicaid.alabama.gov



The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2020 American Medical Association and © 2020 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.





  • For more information, visit http://medicaid.alabama.gov
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