Medicare Part B Payments for Over-the-Counter COVID-19 Tests During the PHE Demonstration

On April 4, 2022, CMS launched the Medicare Over-the-Counter COVID-19 Test (OTC test) Demonstration (Demonstration) to cover and pay for OTC tests for people with Medicare Part B benefits, including people enrolled in Medicare Advantage plans (enrollee), for the remainder of the COVID-19 Public Health Emergency. During the Demonstration period, Medicare covered for each enrollee up to eight OTC tests per calendar month. If an enrollee received more than eight OTC tests in a calendar month, the enrollee may have had to pay out-of-pocket costs for the extra tests unless the enrollee had additional health coverage. We will determine whether Medicare paid eligible pharmacies and health care providers for OTC tests according to the Demonstration.

Announced or Revised	Agency	Title	Component	Report Number(s)	Expected Issue Date (FY)
August 2023	Centers for Medicare and Medicaid Services	Medicare Part B Payments for Over-the-Counter COVID-19 Tests During the PHE Demonstration	Office of Audit Services	WA-23-0034 (W-00-23-35902)	2025