CMS issues guidance on COVID-19 testing and vaccines

NCPA March 1, 2021

On Friday, CMS issued guidance on coverage and reimbursement for COVID-19 diagnostic testing and vaccines. The guidance states that the CARES Act requires plans and issuers to reimburse any provider acting within the scope of their license or authorization for COVID-19 diagnostic testing an amount that equals the negotiated rate, or if the plan or issuer does not have a negotiated rate, the cash rate for the service. As a reminder, pharmacists are qualified persons under the PREP Act, and are authorized to provide COVID-19 testing. This authorization preempts any state and local rules preventing pharmacists from doing so.