CPT Code C9803

CPT Code C9803

BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan are diligently working to ensure the provider community stays abreast of all pertinent information that allows seamless services during the COVID-19 pandemic.

On July 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released the CPT code C9803, which replaced the CPT codes G2023 and G2024.  C9803 is for a hospital outpatient clinic visit for specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), or COVID-19.

CMS developed the codes (C9803, G2023 and G2024) as a payer and not a regulatory agency. The intent for these codes is to allow CMS to process them for payment within their payment system, when the hospital-based laboratory travels offsite to a member to collect a sample or if the hospital-based laboratory collects samples in a drive-through or COVID-19 testing setup location.

For this reason, C9803 should only be used when the hospital-based laboratory travels offsite to a member to collect a sample or if the hospital-based laboratory collects samples in a drive-through or COVID-19 testing setup location.

The primary purpose of C9803 is to identify sample collection.  As a result, CMS will not consider reimbursement for C9803 if one of the following apply:

  • The claim is submitted with other codes
  • The member has other claims on file for services other than the collection a COVID-19 specimen rendered at the same location, on the same date and by the same provider.

If you have any questions, contact Provider Education at Provider.Education@bcbssc.com.