COVID-19 screening and testing coverage
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Policy states that Kern Family Health Care will cover medically necessary screening and testing for COVID-19 for its members and that prior authorization is not required for these services.
No material clinical or coverage changes in this revision.
Coverage Criteria for COVID-19 Screening and Testing
Initial Coverage
Covered when ALL of the following are met
Prior authorization is not required.
Screening and testing for the coronavirus (COVID-19) are covered when medically necessary for Kern Family members. Prior authorization is not required for screening, testing, or treating COVID-19.
Services rendered to Kern Family members for COVID-19 screening and testing should be billed with CPT code U0001.
Billing and Coding
| U0001 | Use CPT code U0001 for services rendered to Kern Family members |
Provider Actions and Billing Guidance
No prior authorization required
Prior authorization is not required for screening, testing, or treating COVID-19 for Kern Family members.
Coverage and provider guidance
Kern Family Health Care will cover medically necessary screening and testing for COVID-19; bill and document services accordingly and follow public health guidance as needed.
- Coverage applies when services are medically necessary for Kern Family members.
- Refer to state and CDC resources linked by the payer for additional guidance.
Billing code for COVID-19 testing
Services rendered to Kern Family members for COVID-19 screening and testing should be billed with CPT code U0001.
No prior authorization (confirmation)
Reinforce that prior authorization will not be required for screening, testing, or treating COVID-19.
Background
This notice communicates payer coverage for medically necessary screening and testing related to the COVID-19 (coronavirus) public health concern and provides links to state and federal public health guidance for additional information.
Definitions
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.