U0005
Infectious disease detection, COVID-19, antigen
Infectious disease detection, COVID-19, antigen is the #231 most-billed Medicaid procedure code, with $636.2M in payments across 41.0M claims from 2018–2024. The national median cost per claim is $15.76.
Total Paid
$636.2M
0.06% of all spending
Total Claims
41.0M
Providers
4K
Avg Cost/Claim
$16
National Cost Distribution
How much do providers bill per claim for U0005? Based on 4K providers billing this code nationally.
Median
$15.76
Average
$15.19
Std Dev
$11.45
Max
$234.30
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.69 and $21.40 per claim for this code.
90% bill between $1.41 and $24.80.
Top 1% bill above $47.22.
About This Procedure
HCPCS code U0005 (Infectious disease detection, COVID-19, antigen) was billed by 4K providers across 41.0M claims, totaling $636.2M in Medicaid payments from 2018–2024. This code was used for 27.3M unique beneficiaries.
Fraud Risk Context
COVID-19 testing codes saw massive billing increases during 2020–2022, with the OIG documenting widespread testing fraud.
Source: HHS OIG COVID-19 Reports
Risk Assessment
This procedure is featured in our investigation: COVID Testing Boom
Read the full analysis for context on billing patterns associated with this code.
Billing Statistics
Median Cost/Claim
$15.76
Providers Billing
4K
National Spending
$636.2M
Avg/Median Ratio
0.96×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for U0005
| # | Provider | Total Paid |
|---|---|---|
| 1 | New York Network Ipa Inc Brooklyn, NY · Exclusive Provider Organization | $33.0M |
| 2 | Infinity Diagnostics Laboratory Inc Teterboro, NJ · Clinical Medical Laboratory | $31.8M |
| 3 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $11.6M |
| 4 | Crown Heights Medical P.c. Monsey, NY · Clinic/Center Multi-Specialty | $10.7M |
| 5 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $10.0M |
| 6 | Bn Medicine Pc New York, NY · Clinic/Center, Primary Care | $10.0M |
| 7 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $9.2M |
| 8 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $8.7M |
| 9 | 1124417357 | $8.6M |
| 10 | Wellnow Urgent Care, P.c. Syracuse, NY · Clinical Medical Laboratory | $8.2M |
| 11 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $7.9M |
| 12 | Curative Labs Inc. San Dimas, CA · Clinical Medical Laboratory | $7.9M |
| 13 | Fulgent Therapeutics Llc. El Monte, CA · Clinical Medical Laboratory | $7.5M |
| 14 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $7.0M |
| 15 | Lifescan Labs Of Illinois Llc Skokie, IL · Clinical Medical Laboratory | $6.8M |
| 16 | Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory | $5.9M |
| 17 | Empire City Laboratories, Inc Brooklyn, NY · Clinical Medical Laboratory | $5.2M |
| 18 | Dart Medical Laboratory, Inc Brooklyn, NY · Clinical Medical Laboratory | $5.1M |
| 19 | Lenco Diagnostic Laboratories,inc. Brooklyn, NY · Clinical Medical Laboratory | $5.0M |
| 20 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $4.7M |
Showing top 20 of 4K providers billing this code