With the PHE ending, testing guidance from CMS is defaulting to CDC recommendations. Currently, the CDC is still recommending a series of viral testing for asymptomatic individuals who have been exposed to an individual positive with COVID-19. The first test should be performed as soon as possible, but not earlier than 24 hours after the exposure, with additional tests being performed at the 48- and 96-hour marks if prior tests are negative. This typically comes out to be testing on day 1, day 3, and day 5. CLIA has suggested changes to approved FDA testing measures on antigen tests with the end of the PHE, and only tests requested per the physician’s order that have been designated for use on asymptomatic individuals per the manufacturer’s instructions should be used in a CLIA certified lab. If facilities wish to use a POC test that does not specify use on someone “suspected” of COVID-19, the facility would be required to obtain a high complexity lab CLIA certification and validate that the deviation returns accurate results. Traditional Medicare will continue to cover the costs of physician ordered testing without cost-sharing through September 2024, but there may be changes in cost coverage for those on MA and private insurance sooner.
The tests being sent by HHS should be authorized for serial testing of asymptomatic individuals, but more information on specifications for tests can be found on the FDA website. Find cost coverage questions for tests via CMS.
