Does Urgent Care Charge for a COVID Test?

Urgent care centers are a convenient option for immediate medical needs, including COVID-19 testing. Many individuals are concerned about whether these facilities charge for a COVID test, and how much. The cost of a COVID-19 test at an urgent care center can vary significantly based on several factors. Understanding these elements is important for patients navigating their healthcare options.

Factors Determining Costs

The cost of a COVID-19 test at an urgent care center is influenced by your insurance coverage, the specific reason for testing, and the type of test administered. Since the Public Health Emergency (PHE) ended in May 2023, the landscape of COVID-19 test coverage has changed, and free testing is no longer universally guaranteed. Private health insurance plans may now subject COVID-19 tests to cost-sharing, network requirements, and medical management reviews.

Medicare Part B generally covers laboratory-based PCR and antigen tests ordered by a healthcare provider without cost-sharing. However, it no longer covers over-the-counter at-home tests. Medicaid and the Children’s Health Insurance Program (CHIP) provided no-cost coverage for laboratory and over-the-counter tests until September 30, 2024, after which coverage varies by state. For individuals without insurance, COVID-19 tests at hospitals and urgent care centers can range from $100 to $300, often incurring additional fees for associated physician services.

The reason for seeking a test also impacts coverage; diagnostic testing for symptoms or exposure may be covered differently than asymptomatic testing for travel or employment. Some insurers may cover medically necessary diagnostic tests but require cost-sharing. PCR tests, which are highly accurate but take longer for results (1-3 days), typically cost between $25 and $300. Rapid antigen tests, while less accurate, offer results in 15-30 minutes and generally cost between $10 and $200.

Understanding Your Bill

When you receive a bill from an urgent care center for a COVID-19 test, it may include charges beyond the test itself. Many urgent care facilities assess a separate office visit fee, which covers the consultation with a healthcare provider and the facility’s operational costs. This fee can apply even if your test is fully covered by insurance; for example, some centers list it around $180 for standard services.

You may also encounter charges for facility fees, which are overhead costs associated with providing care in a clinic setting. These fees contribute to the overall expense, particularly in an urgent care environment. Your health insurance plan’s deductible, co-pay, and co-insurance provisions will determine your out-of-pocket responsibility for these charges. A deductible is the amount you must pay before your insurance starts to cover costs. Co-pays are fixed amounts paid for a service, and co-insurance is a percentage of the cost you share with your insurer after meeting your deductible.

The No Surprises Act, effective January 1, 2022, offers protections against unexpected medical bills, particularly for emergency services and certain out-of-network care. While this act aims to prevent balance billing, where patients are charged the difference between the provider’s fee and what insurance pays, it primarily applies to emergency services and out-of-network care at in-network facilities. Urgent care centers may not always fall under these specific protections, so it is advisable to inquire about all potential charges upfront.

Alternative Testing Avenues

Beyond urgent care centers, several other avenues exist for COVID-19 testing, which might offer lower costs or even free services. Retail pharmacies, such as Walgreens and CVS, often provide rapid COVID-19 antigen tests. Out-of-pocket costs for uninsured individuals range from $20 to $140. Some pharmacies may offer combined flu/COVID-19 rapid tests for around $30, with potential insurance coverage.

Community health centers and local health departments frequently offer low-cost or no-cost testing options. These sites are often supported by federal programs or local initiatives designed to increase access to testing, especially for uninsured or underinsured populations. The Centers for Disease Control and Prevention (CDC) provides a testing locator to help individuals find free testing sites.

At-home COVID-19 tests are also widely available for purchase at pharmacies and online, typically costing between $10 and $25 per kit. While federal programs for free at-home tests were suspended, some health insurance plans may still reimburse for these tests. Private health insurance plans were previously required to cover eight free over-the-counter at-home tests per month per insured individual, though this mandate has changed since the end of the PHE.