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 (2022 fee schedule; adds 0 work RVUs)

710
83rd percentile among 6,326 codes billed · 2022
$154M
98th percentile among 6,326 codes billed · 2022
2.1M
97th percentile among 6,326 codes billed · 2022
104
87th percentile among 6,326 codes billed · 2022
13,635
98th percentile among 6,326 codes billed · 2022
-6.5%
Medicare payment on the code vs 2021; billers -10.2% · 2022

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
Illinois30$29,526,826398,82272742,076
California52$18,190,541246,3341,39717,672
New York23$11,734,018158,1421,04345,412
New Jersey35$11,300,304152,1101,31620,598
Pennsylvania15$8,966,694120,9461,31033,793
Texas53$8,815,725118,72911914,557
Florida32$6,350,20785,25829310,834
Alabama22$5,901,39079,6362615,512
North Carolina12$5,117,79968,87321729,392
Maryland14$4,746,51963,82691118,205
Georgia18$3,182,75242,9094578,788
Oklahoma19$2,595,11834,9502248,645
Ohio11$1,269,52117,0943347,055
Washington254$1,153,29516,07933169
Puerto Rico12$26,7743652760

Not listed: 30 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 2022.

Top metro areas

observed calculated calculated calculated calculated
Chicago-Naperville-Elgin, IL-IN28$29,287,025395,597553
New York-Newark-Jersey City, NY-NJ45$20,973,791282,5121,565
Los Angeles-Long Beach-Anaheim, CA36$12,529,579169,9081,625
Birmingham, AL20$4,695,43363,37223
Dallas-Fort Worth-Arlington, TX19$4,514,84760,734256
Houston-Pasadena-The Woodlands, TX26$4,099,43955,297103
Washington-Arlington-Alexandria, DC-VA-MD-WV15$4,035,55954,2871,055
Atlanta-Sandy Springs-Roswell, GA11$2,142,15028,851544
Miami-Fort Lauderdale-West Palm Beach, FL17$1,562,27920,998205
Seattle-Tacoma-Bellevue, WA149$670,2839,56030
Portland-Vancouver-Hillsboro, OR-WA107$529,0257,13934
San Juan-Bayamón-Caguas, PR11$25,51734828

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 12 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing U0004 nationally

Clinical Laboratory accounts for 97% of payment for U0004 nationally in 2022, across 11 specialties on claims.

observed calculated calculated calculated calculated calculated
Clinical Laboratory34348%$149,068,97897%2,010,7635,862
Pathology172.4%$2,550,9631.7%34,3762,022
Family Practice689.6%$317,6070.21%4,32264
Gastroenterology233.2%$268,4870.17%3,665159
Nurse Practitioner456.3%$236,7620.15%3,20671
Internal Medicine517.2%$214,5110.14%2,92057
Physician Assistant253.5%$158,3270.10%2,15286
Pulmonary Disease121.7%$42,4350.03%57548
General Surgery121.7%$36,3850.02%49641
Orthopedic Surgery142.0%$29,1890.02%39929
Cardiology152.1%$27,7930.02%37725

Not listed: 27 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 2022.

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