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HCPCS U0001 · Level II · code

U0001: Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel, HCPCS Level II code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); Clinical Laboratory Fee Schedule: 26CLABQ4 (CY2026 Q4) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and Clinical Laboratory Fee Schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for U0001

Medicare payment
$35.92
CLFS national limitation amount
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
2
MAI 3
OPPS status
SI A
Services not paid under OPPS; paid under fee schedule or other payment system
NCCI PTP pairs
1
1 hospital outpatient
LCDs and articles
4 / 4

TL;DR

HCPCS Level II U0001 reads "Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel" in the October 2026 file; it dates from 2020. The 2026 Q4 clinical laboratory fee schedule pays U0001 $35.92 (national limitation amount). Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 3, Nature of Analyte); hospital outpatient 2 (MAI 3, Nature of Analyte). In the NCCI PTP files v323r0 U0001 appears in 0 practitioner pairs as column 2 and 1 as column 1, and in 0 hospital outpatient pairs as column 2 and 1 as column 1. 4 active LCDs and 4 billing and coding articles list U0001 across 16 states: L39044 (MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing), L38988 (MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing), A58710, A58720. OPPS status indicator A: Services not paid under OPPS; paid under fee schedule or other payment system. HCPCS record: BETOS T1H (lab tests - other (non-Medicare fee schedule)); pricing indicator 22; type of service 5 (diagnostic laboratory). Nearby codes: U0002, R0070, R0075, M0201.

U0001 descriptor and code status

The October 2026 HCPCS Level II file describes U0001 as “Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel”. It sits in the U section (coronavirus diagnostic laboratory tests), listed with the other Other Level II codes. Although searches often call it the "U0001 CPT code", U0001 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.

HCPCS file attributes of U0001
FieldValue
Short descriptor2019-ncov diagnostic p
Added to HCPCS2020-02-04
Last actionN (no maintenance), effective 2020-02-04
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator22: clinical lab fee schedule, priced by the contractor
BETOS categoryT1H: lab tests - other (non-Medicare fee schedule)
Type of service5: diagnostic laboratory

Medicare payment for U0001

The 2026 Q4 clinical laboratory fee schedule pays U0001 $35.92 (national limitation amount). The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Clinical Laboratory Fee Schedule (26CLABQ4)

U0001 is paid at $35.92 (national limitation amount). Laboratory fee schedule payments carry no beneficiary coinsurance or deductible.

Hospital outpatient (OPPS Addendum B)

Status indicator A (Services not paid under OPPS; paid under fee schedule or other payment system), with no separate OPPS payment rate.

Medically Unlikely Edits for U0001

Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 3, Nature of Analyte); hospital outpatient 2 (MAI 3, Nature of Analyte). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for U0001 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services23 Date of Service Edit: ClinicalNature of Analyte
Facility outpatient hospital23 Date of Service Edit: ClinicalNature of Analyte

The MUE lookup for U0001 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, U0001 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 1 (0% modifier-allowed); 2 earlier pairs have been deleted.

Column-2 codes bundled into U0001 (practitioner)
Column-2 codePairs
U0002 Covid-19 lab test non-cdc1

In the hospital outpatient PTP file v323r0, U0001 is the column-2 (bundled) code in 0 active pairs and the column-1 code in 1 (0% modifier-allowed); 2 earlier pairs have been deleted.

Column-2 codes bundled into U0001 (hospital outpatient)
Column-2 codePairs
U0002 Covid-19 lab test non-cdc1

U0001 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check U0001 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for U0001

4 active Local Coverage Determinations and 4 billing and coding articles list U0001. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

  • MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing, LCD L39044 · Wisconsin Physicians Service Insurance Corporation
  • L38988 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing · Palmetto GBA
  • L39001 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing · Noridian Healthcare Solutions, LLC
  • L39038 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing · CGS Administrators, LLC
Billing and Coding Articles listing U0001
ArticleTitleContractor(s)Related LCD
A58710Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification TestingPalmetto GBAL38988
A58720Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification TestingNoridian Healthcare Solutions, LLCL39001
A58747Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification TestingCGS Administrators, LLCL39038
A58761Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification TestingWisconsin Physicians Service Insurance CorporationL39044

Denials to expect on U0001

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists U0001

CARC 151 · N362

units of U0001 exceed the practitioner MUE of 2 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for U0001 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for U0001 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS U0001

What does HCPCS code U0001 describe?

"Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel" (short descriptor "2019-ncov diagnostic p"), in the U section (coronavirus diagnostic laboratory tests). Added 2020-02-04.

Is U0001 a CPT code?

No. U0001 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set. Searches for "U0001 CPT code" mean this Level II code.

What does Medicare pay for U0001?

The 2026 Q4 clinical laboratory fee schedule pays U0001 $35.92 (national limitation amount).

How many units of U0001 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 2 (MAI 3, Nature of Analyte); hospital outpatient 2 (MAI 3, Nature of Analyte). For the practitioner MUE (MAI 3), units above 2 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover U0001?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 4 active LCDs and 4 billing and coding articles list U0001 across 16 states: L39044 (MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing), L38988 (MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing), A58710, A58720.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.