CMS Issues Guidance on Private Insurance Coverage for COVID-19 Diagnostic Tests

CMS has also released guidance clarifying that private group health plans and issuers generally must cover COVID-19 diagnostic tests for covered individuals who are asymptomatic and have had no known exposure to the virus, with no cost-sharing, prior authorization, or other medical management requirements. The guidance, which builds on an executive order issued in January 2021, still allows plans to deny coverage for COVID-19 tests for public health surveillance or employment purposes. To learn more, click here.

All Curi recommendations are based on current CDC criteria at the time of publication. CDC guidance for SARS-CoV-2 infection may, or may not, be adopted by state and local health departments to respond to rapidly changing local circumstances. Providers should always check with their local health department to see if the CDC’s guidance on any given topic has been modified (particularly if more restrictive) from the CDC’s recommended guidelines. Follow this link https://www.cdc.gov/publichealthgateway/healthdirectories/index.html for contact information to your state/local health department. If local recommendations vary from those of the CDC, and you are unsure what recommendations to follow, then it is safer to follow the more restrictive guidelines/recommendations.