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Why is claim reimbursement eligibility for diagnostic testing services performed by independent labs different than claim reimbursement eligibility for such services performed by hospitals (including hospital labs) or physicians?

Why is claim reimbursement eligibility for diagnostic testing services performed by independent labs different than claim reimbursement eligibility for such services performed by hospitals (including hospital labs) or physicians?

Independent labs do not always know the reason for testing when ordered by another provider and they are dependent on the diagnosis information indicated by the provider. Therefore, HRSA reimburses for specific COVID-19 diagnostic testing services (individual procedure codes) for any diagnosis only when performed by independent labs.

Eligibility Questions
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