Low Reimbursements Are Causing Some Doctors to Stop Testing for Covid

Dr. Robin Larabee was thrilled to start offering coronavirus testing at her pediatrics practice in Denver last fall. Testing for children is often scarce, and her new machines could return results within minutes.

She quickly discovered an unexpected obstacle: a major health insurer that paid her less than the cost of the test itself. Each kit Dr. Larabee purchased for her machines cost about $41, but the insurer sent back half that amount each time she submitted a claim.

Across the country, some doctors are seeing reimbursement rates so low that they do not cover the cost of the test supplies, jeopardizing access to a tool experts see as crucial to stopping the virus’s spread. “I’ve gone up the food chain, and gotten as far as I can, and they just tell me this is the rate,” she said.

She doesn’t use her new machines for that health plan’s enrollees anymore, instead sending their tests to an outside laboratory. That extra step means results take days rather than minutes to come back.

With new variants of coronavirus emerging, experts say testing will be especially important. But the low fees have led some doctors to stop testing certain patients, or to forgo testing altogether. The problem of low reimbursement rates appears to be most common with pediatricians using in-office rapid testing.