U0004 HCPCS code: 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
U0004 is the HCPCS Level II code for 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. CMS terminated U0004 on 2023-05-11; do not bill it for later dates of service. In 2023 Medicare paid an average of $73.48 per service for U0004 across 312,752 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume fell 85% from 2022 to 2023 (2,073,413 to 312,752 services). In 2023, about 700 clinicians billed Medicare for U0004 for 89,009 beneficiaries; Illinois, California, New Jersey accounted for 47% 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 U0004 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 700 |
| Medicare beneficiaries | 89,009 |
| States with claims | 37 |
| Share of services in top 3 states (Illinois, California, New Jersey) | 47% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for U0004, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,073,413 | 478,771 | $74.13 | $74.13 |
| 2023 | 312,752 | 89,009 | $73.48 | $73.48 |
States with the most U0004 services (2023)
| State | Services | Avg. paid |
|---|---|---|
| Illinois | 78,267 | $73.50 |
| California | 38,114 | $73.47 |
| New Jersey | 31,691 | $73.50 |
| New York | 24,997 | $73.50 |
| Louisiana | 22,292 | $73.50 |
What changed for U0004
- 2020-04-14: U0004 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 U0004?
U0004 is the HCPCS Level II code for 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. Short descriptor: "Cov-19 test non-cdc hgh thru".
How much does Medicare pay for U0004?
In 2023, the average Medicare payment was $73.48 per service (average allowed $73.48).
Does Medicare cover U0004?
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
- U0003 — 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
- 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
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under U0004
- Watch U0004 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for U0004
Sources: CMS HCPCS Level II release October 2025; 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.