R13633OTN

Transmittal #
R13633OTN
Issue Date
2026-02-23
Subject

Billing Code Clarification for National Coverage Determination (NCD) 210.13 Screening
for Hepatitis C Virus (HCV) in Adults

Implementation Date
2026-07-06
CR #
14388
Provider Education
MLN Connects Newsletter Message
Provider Education Release Date
2026-02-26
Publication #
100-20
Transmittal Year
2026

MLN Connects® Newsletter Message

Screening for Hepatitis C Virus National Coverage Determination: Clarified Billing Requirements

CMS clarified billing requirements for the Screening for Hepatitis C Virus in Adults National Coverage Determination 210.13. We’ll pay for HCPCS code G0567 with modifier QW when billed by Clinical Laboratory Improvement Amendment (CLIA) waived laboratories and without modifier QW when billed by non-CLIA waived laboratories, effective retroactive to June 27, 2024.

There’s no change to the policy. Your Medicare Administrative Contractor (MAC) will adjust claims you bring to their attention.

See the instruction to your MAC (PDF) for more information.

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