CMS Guidance on Optional Uninsured COVID-19 Testing Coverage

June 3, 2020

The Centers for Medicare & Medicaid Services (CMS) released guidance to states implementing the Optional COVID-19 Testing (XXIII) Group. This coverage, established by the Families First Coronavirus Response Act (FFCRA), is for testing and testing-related services provided to uninsured individuals.

The guidance provides details on implementation requirements related to coverage application, eligibility verification, hospital presumptive eligibility, patient notices, claims submission and data reporting. The guidance also outlines options and flexibilities within these requirements available to states participating in the Optional COVID-19 Testing Group.

In addition to this guidance, CMS published FFCRA and Coronavirus Aid, Relief, and Economic Security (CARES) Act Frequently Asked Questions (FAQs) on April 13. Section B of this FAQ document provides additional details on eligibility requirements, benefits, and the Federal Medical Assistance Percentage (FMAP) available for coverage provided under the Optional COVID-19 Testing Group.