February 3, 2022
On January 15, 2022, thefederal mandate requiring health plans to cover member-purchased over-the-counter(OTC) COVID-19 tests went into effect. These are for diagnostic purposes onlyand use a specific claimform. Members may purchase up to 8 tests per coveredmember per 30-day period. The tests are covered as individual tests and not asa package (i.e., most tests come as a package of 2). Read our FAQ information on which tests are covered and get alink to the claim form.
COVID-19 diagnostic testshandled in a provider’s office should continue to be billed as a medical serviceand shouldn’t use the member-submitted form. For information on codingdiagnostic tests, read our COVID-19 FAQ.
The federal government alsoreleased information on their test kits, which can be ordered now through covidtests.gov.There is a limit of 4 tests per household. Our COVID-19 FAQ has the latest information on date extensions, newcodes, and other requirements.