CMS cements fresh round of COVID-19 waivers, upping payments, expanding telehealth

May 19th, 2020

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews CMS’s April 30 COVID-19 emergency policy changes and explains how they affect payment and access for telehealth, telephone evaluation and management services, COVID-19 testing, specimen collection, outpatient department billing, and therapy services. It is aimed at coding, billing, compliance, and practice management professionals who need to track temporary Medicare policy changes during the public health emergency. The discussion focuses on broad categories of expanded coverage and payment updates rather than detailed coding instructions.

Why This Topic Matters

These temporary CMS changes alter how providers report and receive payment for several COVID-19-related and telehealth-related services, so practices need to know which service categories are affected and when the updates apply.

Article Sections

  1. Telephone services get a raise

    Discusses updated Medicare payment and coverage treatment for telephone-based evaluation and management services during the public health emergency. The section also notes timing and documentation considerations at a high level.

  2. Expanded diagnostic testing options

    Covers CMS changes affecting COVID-19 laboratory testing, ordering, specimen collection, and payment for related testing services. It also describes broader access to antibody tests and certain at-home testing options.

  3. Outpatient departments can retain rates

    Summarizes temporary payment flexibility for some off-campus provider-based outpatient departments, including exception requests and relocation-related policy changes.

  4. More telehealth updates

    Reviews expanded telehealth participation for therapy disciplines and related Medicare coverage updates. It also notes that CMS is using a faster process for adding additional telehealth services.

What You Will Learn

  • Which broad CMS COVID-19 emergency policy areas were updated
  • How Medicare telehealth and telephone service coverage was expanded
  • What categories of COVID-19 testing and specimen collection received new payment attention
  • Which outpatient and therapy service groups were affected by temporary CMS flexibility
  • How CMS is changing its process for adding telehealth services during the emergency

Who Should Read This

  • Medical coders
  • Billing specialists
  • Compliance professionals
  • Revenue cycle staff
  • Practice managers
  • Healthcare providers

Codes Discussed

  • CPT: 99441
  • CPT: 99442
  • CPT: 99443
  • CPT: 87635
  • CPT: 86328
  • CPT: 86769
  • CPT: 99211
  • HCPCS Level II: U0001
  • HCPCS Level II: U0002
  • HCPCS Level II: U0003
  • HCPCS Level II: U0004
  • HCPCS Level II: C9803
  • HCPCS Level II: G2023
  • HCPCS Level II: G2024

Code Ranges Discussed

  • CPT: 99441-99443

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