decisionhealth Newsletters, Coder Pink Sheets - 2020 Issue 6 (June)
CMS cements fresh round of COVID waivers, upping payments, expanding telehealth
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Article Overview
This premium article reviews a broad CMS update issued during the COVID-19 public health emergency and explains how it changes access, billing, and payment for several categories of services. It is aimed at coders, billers, and clinical practices that need to understand temporary Medicare policy adjustments, telehealth expansions, and testing-related reimbursement changes. The discussion covers telephone E/M services, COVID-19 diagnostic and antibody testing, outpatient department payment status, and expanded telehealth availability for therapy and other services.
Why This Topic Matters
CMS emergency policy changes can quickly alter which services are payable, who may furnish them, and how claims should be reported. Practices need a clear view of these updates to align operations, monitor reimbursement, and support compliant billing during the pandemic period.
Article Sections
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Telephone services get a raise
Summarizes Medicare payment updates and coverage context for telephone-based evaluation and management services during the public health emergency.
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Telephone E/M services
Introduces the telephone E/M service category discussed in the article and identifies the scope of the covered service list.
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Expanded diagnostic testing options
Covers CMS changes affecting COVID-19 testing access, ordering, and payment for different testing settings and test types.
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Outpatient departments can retain rates
Describes temporary payment-related changes for certain off-campus provider-based outpatient departments and related relocation flexibility.
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More telehealth updates
Reviews additional CMS telehealth expansions affecting therapy services, practitioner participation, and the process for adding more services during the emergency.
What You Will Learn
- How CMS adjusted telehealth and telephone-based service policy during the COVID-19 emergency
- What categories of COVID-19 testing and related laboratory services are addressed
- How outpatient department payment policy was temporarily modified
- Which provider types were newly included in telehealth-related flexibility
- How CMS described its process for adding additional telehealth services during the emergency
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Compliance staff
- Physician practices
- Therapy providers
- Hospital outpatient departments
Codes Discussed
Code Ranges Discussed
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