Requirements for Universal Hepatitis C Testing Information for Health Care Providers

Are you screening for Hepatitis C at each pregnancy?

Effective May 3, 2024, New York State health care providers are required to provide hepatitis C testing to all pregnant people during each pregnancy and document the result prominently in the medical record at or before the time of hospital admission for delivery. HCV screening may occur at any time during pregnancy.

Providers are also expected to offer a hepatitis C screening test to all persons 18 years and older and persons under 18 with a risk indication.

Expanding hepatitis C screening for all adults, particularly during pregnancy, helps reduce stigma and enhance timely diagnosis and linkage to curative treatment. While treatment has not yet been FDA-approved for use during pregnancy, treatment can be considered during pregnancy on an individual basis after a patient-physician discussion about the potential risks and benefits. Furthermore, Medicaid coverage for pregnant individuals during the post-partum period is increased from 60 days to 12 months, making HCV screening during pregnancy an important opportunity to identify future care needs for both the pregnant person and their baby.

Fact Sheet

  • New cases of hepatitis C are on the rise, particularly among reproductive age adults. Most new infections occur among adults 20-39 years of age. Hepatitis C among pregnant people has increased over the last decade.
  • Most people with hepatitis C have no symptoms. Almost half of people with hepatitis C are unaware of their infection. If left untreated, hepatitis C can lead to serious liver disease.
  • Hepatitis C is curable. More than 90 percent of people with HCV can be treated and cured with 8-12 weeks of oral therapy.
  • Testing is the first step to getting curative treatment and eliminating hepatitis C in New York State.

Effective May 3, 2024, New York State requires a hepatitis C screening test be provided to:

  • Every person 18 years and older.
  • People younger than 18 if there is indication of risk.
  • All pregnant people during each pregnancy. Screening test results must be recorded in the pregnant person's medical record at or before the time of hospital admission for delivery.

If the screening test is reactive, a hepatitis C RNA test must be performed on the same specimen or a second specimen collected at the same time as the initial test, to confirm diagnosis of current hepatitis C infection.

If the hepatitis C RNA test is detectable, the health care provider must either offer the person follow-up hepatitis C health care and treatment, or refer the person to a health care provider who can.

New York State requires people under age 18 be provided a hepatitis C screening test if they have a risk. For example, if they:

  • Have ever shared needles, syringes, or any other equipment for preparing and injecting drugs.
  • Got a tattoo or body piercing from an unlicensed artist, such as on the street or while in jail.
  • Snorted drugs.
  • Have HIV.
  • Were exposed to hepatitis C at birth.
  • Were exposed to blood on the job through a needlestick, or through injury with a sharp object.

Providers who must offer hepatitis C testing include physicians, physician assistants, and nurse practitioners, or midwives providing primary care regardless of setting, and without regard to board certification.

The medical settings where providers are required to offer a hepatitis C screening test are:

  • Hospital (inpatient).
  • Hospital outpatient clinics.
  • Emergency departments.
  • Other health care settings where primary care services are being offered.
  • Medicaid and Medicare currently cover hepatitis C screening for all adults and people at risk.
  • People with private insurance should refer to their policy, or contact their carrier to see if the test is covered.

Current testing guidance recommends a two-step testing sequence for diagnosis of hepatitis C infection. Testing is initiated with a hepatitis C antibody test. When this test is reactive, a hepatitis C RNA test is performed to confirm diagnosis of current infection. CDC recommends single-visit sample collection and use of reflex testing[1] to support complete testing for hepatitis C.

Test Type CPT Code
Hepatitis C antibody test 86803
HCV RNA Qualitative 87521
HCV RNA Quantitative 87522

NYS Medicaid reimburses laboratories for reflex testing for confirmation of hepatitis C antibody screening tests without additional written orders from the physician. The preprinted requisition form must indicate that the test will be used in the reflex algorithm.

  • Health care providers, health care facilities, laboratories, and local and State health departments all share the responsibility for reporting, follow-up, and control of communicable diseases.
  • Reporting of suspected, or confirmed hepatitis C is mandated under the New York State Sanitary Code (10NYCRR 2.10). This includes patients with a positive hepatitis C screening test and/or a positive hepatitis C RNA test.
  • Reports should be made to the local health department in the county in which the patient resides, and they need to be submitted within 24 hours of diagnosis. Information on how to report is available at: Communicable Disease Reporting.
  • Providers may be contacted by local health departments for additional information and should provide requested information promptly.

The New York State Department of Health AIDS Institute's online directory provides information regarding participating hepatitis C providers across NYS. To find a hepatitis C provider, go to: AIDS Institute's Provider Directory

The New York State Department of Health AIDS Institute Clinical Education Initiative (CEI) offers training, intensive preceptorship programs, tele-education, technical assistance, and additional clinical tools to enhance provider capacity to deliver hepatitis C services. Visit: https://ceitraining.org/

Providers can find more information about the New York State requirement for universal hepatitis C testing by going to: Hepatitis C Information

Footnotes

  1. [1] Cartwright EJ, Patel P, Kamili S, Wester C. Updated Operational Guidance for Implementing CDC's Recommendations on Testing for Hepatitis C Virus Infection. MMWR Morb Mortal Wkly Rep 2023;72:766–768. DOI: http://dx.doi.org/10.15585/mmwr.mm7228a2

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