What billing rules apply to HIV testing in EDs?
The following is a summary of rules which apply to billing for HIV testing by EDs. • EDs may bill the HIV Testing Visit only when rapid tests, which provide results in a single visit, are used. The costs of the rapid test kit and controls are included in the visit rate. • Same-day billing is allowed for the HIV Testing Visit and an ED visit. • The ED must provide HIV counseling and linkage to medical services, including confirmatory testing, when a patient’s test result is a preliminary positive. In these cases, the hospital may bill an ED visit, an HIV Testing Visit, and an HIV Counseling (Positive) Visit on the same day. • EDs may not bill the HIV Primary Care Medicaid Program visits for patients who are admitted for inpatient services.
