Put modifier CR on waiver-related claims — but not telehealth

Why This Topic Matters

Accurate modifier reporting during the COVID-19 public health emergency affects whether claims properly reflect waiver-based services and related payment treatment. The article helps coding and billing professionals recognize the general categories of claims addressed by CMS guidance and the organizations and manual references involved.

Article Sections

1. CMS guidance on waiver-related modifier use

   Introduces CMS instructions for reporting claims affected by public health emergency waiver flexibilities. It frames the article around Medicare fee-for-service guidance and related CMS references.

2. Formal waivers and blanket waivers during the PHE

   Discusses the general waiver framework CMS describes for claims tied to the COVID-19 emergency. It covers the types of waiver activity referenced in the guidance and the broader policy context.

3. Telehealth claims and related reporting

   Explains that telehealth claims are treated separately from other waiver-based claims in the guidance. It notes the reporting framework referenced for remote services during the emergency period.

4. Examples of waiver-related service categories

   Reviews several broad categories of services and billing situations mentioned in the article as being affected by the emergency waivers. These examples are presented as general subject areas rather than detailed instructions.

5. COVID-19 testing-related cost-sharing guidance

   Covers the separate CMS guidance addressed to testing-related services during the pandemic. It distinguishes this topic from the waiver-related reporting discussed earlier in the article.

6. Resources

   Lists CMS and MLN references cited by the article for readers seeking the underlying guidance. The section serves as source material and further reading.