HCPCS U0004

2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r (CMS descriptor)

Other services

259
76th percentile among 6,405 codes billed · 2023
$23M
93rd percentile among 6,405 codes billed · 2023
311K
91st percentile among 6,405 codes billed · 2023
185
91st percentile among 6,405 codes billed · 2023
6,338
97th percentile among 6,405 codes billed · 2023
-85.1%
Medicare payment on the code vs 2022; billers -63.5% · 2023

Trend

Medicare payment on the code

$0$100M2020: $179M paid20202021: $164M paid20212022: $154M paid20222023: $23M paid2023$23M$0$100M2020: $179M paid20202021: $164M paid20212022: $154M paid20222023: $23M paid2023$23M$0$100M2020: $179M paid20202021: $164M paid20212022: $154M paid20222023: $23M paid2023$23M$0$100M2020: $179M paid20202021: $164M paid20212022: $154M paid20222023: $23M paid2023$23M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2023.

Billers

05002020: 723 providers20202021: 791 providers20212022: 710 providers20222023: 259 providers202325905002020: 723 providers20202021: 791 providers20212022: 710 providers20222023: 259 providers202325905002020: 723 providers20202021: 791 providers20212022: 710 providers20222023: 259 providers202325905002020: 723 providers20202021: 791 providers20212022: 710 providers20222023: 259 providers2023259

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2023.

observed calculated calculated calculated calculated calculated reported
2023259$22,878,109-85%311,3381856,338
2022710$153,549,774-7%2,071,36210413,6350.00
2021791$164,284,235-8%2,191,4967612,4320.00
2020723$178,691,334first year in data1,790,1805514,641

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2023.

By state

observed calculated calculated calculated calculated calculated
Illinois15$5,752,01278,26053419,427
California38$2,798,24938,0864094,065
New Jersey20$2,324,03231,6203617,750
New York16$1,835,95724,9794537,574
Pennsylvania11$1,164,24015,8401896,387
Texas20$807,47110,990452,633
Florida17$187,9402,55765561
Washington24$39,1025632055

Not listed: 29 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2023.

Top metro areas

observed calculated calculated calculated calculated
Chicago-Naperville-Elgin, IL-IN15$5,752,01278,260534
New York-Newark-Jersey City, NY-NJ31$4,071,34855,393384
Los Angeles-Long Beach-Anaheim, CA29$2,157,12729,360455
Houston-Pasadena-The Woodlands, TX12$672,6729,15545
Seattle-Tacoma-Bellevue, WA21$35,79551821

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 5 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing U0004 nationally

Clinical Laboratory accounts for 98% of payment for U0004 nationally in 2023, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory21282%$22,387,20298%304,6361,437

Not listed: 14 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2023.

Top billers of U0004 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations