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 reviews CMS guidance on Medicare claims handling during the COVID-19 public health emergency, with emphasis on waiver-related billing indicators and related modifier updates. It is aimed at coders, billing staff, and compliance professionals who need to understand which kinds of claims fall under formal or blanket waivers, how telehealth claims are treated, and how COVID-19 testing-related claims are identified. The article also references CMS source guidance and the broader emergency waiver framework that applies to provider services during the PHE.
Why This Topic Matters
Correctly identifying waiver-related and emergency-period claims helps providers align Medicare billing with CMS guidance during the COVID-19 public health emergency and reduces the risk of claim processing problems.
Article Sections
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Coding
Overview of CMS guidance on emergency-period Medicare billing and the role of waiver-related modifiers. The section introduces the broader context for claims affected by COVID-19 public health emergency flexibilities.
What You Will Learn
- How CMS framed waiver-related Medicare claim reporting during the COVID-19 public health emergency
- Which general categories of claims were addressed in the guidance
- How telehealth and testing-related claims were discussed in relation to emergency modifiers
- What types of CMS source materials and emergency waiver references the article cites
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Compliance professionals
- Medicare providers
Codes Discussed
Modifiers Discussed
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