decisionhealth Newsletters, Part B News - 2020 Issue 5 (May)
Put modifier CR on waiver-related claims — but not telehealth
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Article Overview
This article covers CMS instructions for Medicare claims submitted under COVID-19 public health emergency waiver authority, including which situations call for specific modifiers and which claims are handled differently. It is relevant to coders, billers, and compliance staff working with Medicare fee-for-service claims, telehealth billing, and emergency waiver-based services. The piece also references CMS source documents and related guidance from the MLN Matters series.
Why This Topic Matters
Waiver-related Medicare billing during the COVID-19 public health emergency created special claim-reporting requirements that affected payment and compliance. Understanding the CMS guidance helps providers and billing teams apply the correct claim indicators in waiver-based situations and avoid processing issues.
What You Will Learn
- How CMS ties Medicare claim reporting to formal waiver authority during the COVID-19 public health emergency
- Which types of waiver-based services are discussed in the guidance
- How telehealth claims are treated differently from other waiver-related claims
- What related Medicare billing exceptions and reporting updates are mentioned
- Which CMS resources and MLN Matters documents support the guidance
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Compliance staff
- Medicare providers
- Healthcare administrators
Codes Discussed
Modifiers Discussed
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