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 Work RVU per service none (2021 fee schedule; adds 0 work RVUs)

791
84th percentile among 6,253 codes billed · 2021
$164M
98th percentile among 6,253 codes billed · 2021
2.2M
97th percentile among 6,253 codes billed · 2021
76
83rd percentile among 6,253 codes billed · 2021
12,432
98th percentile among 6,253 codes billed · 2021
-8.1%
Medicare payment on the code vs 2020; billers +9.4% · 2021

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
New York25$28,682,520382,456833108,998
New Jersey33$20,465,076272,89999733,953
Illinois21$15,822,450210,96060934,265
Florida38$11,297,700150,63323414,032
Texas61$10,274,232137,0051377,735
Pennsylvania19$9,776,432130,3501,22224,179
California50$8,459,041112,81341211,071
Maryland18$6,896,57391,96745023,898
Alabama36$4,616,36061,585299,174
North Carolina15$4,488,22859,84324517,992
Georgia25$3,172,98442,3571999,133
Michigan12$2,252,56030,0401,6778,841
Ohio15$1,995,35526,6121537,942
Oklahoma27$1,651,18022,016605,494
Washington263$1,337,66518,59433171

Not listed: 27 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ47$48,302,571644,0651,277
Chicago-Naperville-Elgin, IL-IN18$15,442,275205,891178
Los Angeles-Long Beach-Anaheim, CA36$6,979,47593,075403
Houston-Pasadena-The Woodlands, TX28$4,840,42564,553277
Dallas-Fort Worth-Arlington, TX17$4,554,35760,725184
Washington-Arlington-Alexandria, DC-VA-MD-WV18$4,387,55758,509327
Miami-Fort Lauderdale-West Palm Beach, FL15$4,194,02555,920283
Birmingham, AL32$3,473,66046,34929
Atlanta-Sandy Springs-Roswell, GA17$1,846,92524,62673
Seattle-Tacoma-Bellevue, WA164$774,26511,07728
Portland-Vancouver-Hillsboro, OR-WA97$608,3258,11643
Oklahoma City, OK11$274,9153,66557
Boston-Cambridge-Newton, MA-NH22$225,8253,01523
San Juan-Bayamón-Caguas, PR13$51,97569346

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 14 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing U0004 nationally

Clinical Laboratory accounts for 95% of payment for U0004 nationally in 2021, across 12 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory32141%$156,817,73395%2,091,5896,516
Pathology212.7%$4,401,7072.7%58,7092,796
Family Practice8611%$422,0160.26%5,69966
Nurse Practitioner638.0%$388,0900.24%5,19082
Gastroenterology293.7%$386,4250.24%5,204179
Internal Medicine607.6%$289,3750.18%3,87465
Physician Assistant384.8%$231,0650.14%3,12682
Cardiology192.4%$74,5500.05%1,00553
Pulmonary Disease141.8%$61,7250.04%82859
Orthopedic Surgery192.4%$43,8750.03%59932
Urology131.6%$42,3750.03%56944
General Surgery131.6%$39,9750.02%53941

Not listed: 29 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 2021.

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