U0003 HCPCS code: Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r
U0003 is the HCPCS Level II code for infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r. CMS terminated U0003 on 2023-05-11; do not bill it for later dates of service. In 2023 Medicare paid an average of $73.47 per service for U0003 across 1,301,164 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume fell 80% from 2022 to 2023 (6,668,388 to 1,301,164 services). In 2023, about 3,950 clinicians billed Medicare for U0003 for 554,612 beneficiaries; California, Illinois, New Jersey accounted for 68% of services.
Code details
| Field | Value |
|---|---|
| Section | U codes — Coronavirus diagnostic panel / laboratory |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 22 |
| BETOS category | T1H |
| Added | 2020-04-14 |
| Last action effective | 2023-05-12 |
| Terminated | 2023-05-11 |
Who bills U0003 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 3,950 |
| Medicare beneficiaries | 554,612 |
| States with claims | 51 |
| Share of services in top 3 states (California, Illinois, New Jersey) | 68% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for U0003, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 6,668,388 | 2,488,445 | $74.16 | $74.16 |
| 2023 | 1,301,164 | 554,612 | $73.47 | $73.47 |
States with the most U0003 services (2023)
| State | Services | Avg. paid |
|---|---|---|
| California | 446,240 | $73.49 |
| Illinois | 329,704 | $73.49 |
| New Jersey | 105,772 | $73.43 |
| North Carolina | 88,546 | $73.50 |
| Texas | 56,743 | $73.42 |
What changed for U0003
- 2020-04-14: U0003 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code U0003?
U0003 is the HCPCS Level II code for infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r. Short descriptor: "Cov-19 amp prb hgh thruput".
How much does Medicare pay for U0003?
In 2023, the average Medicare payment was $73.47 per service (average allowed $73.47).
Does Medicare cover U0003?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related U00 codes
- U0001 — Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel
- U0002 — 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc
- U0004 — 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r
- U0005 — Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2
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Next steps
- Run a reimbursement report for a device billed under U0003
- Watch U0003 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for U0003
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.