4/4/2022 - OTC COVID Tests for Medicare Patients

OTC Covid Tests for Medicare Patients

Effective immediately Medicare Part B will cover up to 8 at home COVID tests per month, per beneficiary.  The reimbursement for these tests will be $12 each.  You will need to get the patient's red, white, and blue card (MBI number) for billing.  These will NOT be billed to the Medicare Advantage coverage.  ALL Medicare Part Band Part C (Medicare Advantage) will be billed and paid through the Medicare Part B plan.

You can submit these claims to EBS using our BIN 610160 and the PCN for your Medicare - (State).  This PCN can be found on the EBS website ebsservice.com under the header of NCPDP Billing Services.  When looking for the appropriate Medicare PCN for these tests you will want to use the one that is labeled Medicare - (your state) (example Medicare-Missouri).  This is the same plan you would have used to bill your vaccine administration.

Be sure to use the NDC for your test(s).  You will want to use the actual number of tests (NOT the number of boxes) you are dispensing for your quantity.

Please submit your claims with the diagnosis code of

These tests have been added to our system for billing.  If you have other NDC's that you will be using, please notify us by email at mstoner@ebsservice.com and they will need to be added prior to transmitting your NCPDP claim(s).

Quickvue At-Home Covid-19 Test  NDC #  14613033972    Qty 2

Inteliswab Covid-19 Rapid Test  NDC #   8337000158    Qty 2

IHEALTH Covid-19 AG Rapid Test   NDC #  56362000589    Qty 2

Flowflex Covid-19 AG Home Test    NDC #  82607066027    Qty 2

Flowflex Covid-19 AG Home Test   NDC #  82607066026    Qty 1

Ellume Covid-19 Home Test   NDC #  56964000000    Qty 2

Carestart Covid-19 AG Home Test NDC #  50010022431    Qty 2

Binaxnow Covid-19 AG Self Test  NDC #  11877001140    Qty 2

Pixel Covid-19 Home Collection Kit   NDC #  42022224    Qty 1

Lucira Check-It Covid-19 Test    NDC # 10055097004    Qty 1

Everlywell Covid-19 Home Collection Kit  NDC #  51044000842    Qty 1

You will use diagnosis code of Z20.828

If the patient has received their maximum allotment of 8 tests per month, your claim could be denied.  It is advised that providers have the patient's credit card or ACH information on file to collected any amounts due.

Electronic Billing Services, Inc
138 N Prairie St
Sikeston, MO  63801
Phone: (573) 472-3613
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