decisionhealth Newsletters, Part B News - 2020 Issue 5 (May)
Test payment alert: Some COVID-19 tests are CLIA-waived, require modifier
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Article Overview
This article covers a CMS update affecting billing for COVID-19 laboratory testing, including CLIA-waived status, the related modifier requirement, and timing tied to the agency’s announcement. It is relevant to laboratory billing staff, coders, and compliance teams tracking Medicare guidance for pandemic-era test claims and evolving federal policy.
Why This Topic Matters
Laboratories and billing teams need to know when a test falls under CLIA-waived billing rules so claims can be submitted consistently with current CMS guidance. The article also places the update in the broader context of rapidly changing COVID-19 testing policy and federal authorization status.
What You Will Learn
- How CMS updates can affect billing for COVID-19 laboratory testing
- How CLIA-waived status relates to Medicare claim processing
- Why federal authorization and timing matter for test billing guidance
- What types of organizations monitor and issue laboratory testing policy changes
Who Should Read This
- Medical coders
- Laboratory billing staff
- Compliance officers
- Revenue cycle professionals
- Healthcare administrators
Codes Discussed
Modifiers Discussed
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