Healthcare News: CMS permits hospitals to bill for telehealth, expands diagnostic testing for COVID-19

May 5th, 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 summarizes CMS guidance issued during the COVID-19 public health emergency that affects hospital outpatient billing, physician telehealth reimbursement, and diagnostic testing coverage. It is aimed at hospitals, physicians, billing staff, and other healthcare organizations tracking temporary pandemic-related policy changes, including telehealth delivery options, outpatient department billing treatment, and testing-related coverage updates.

Why This Topic Matters

The article explains temporary CMS policy changes that affect how facilities and practitioners bill for telehealth and COVID-19-related testing during the public health emergency. It is useful for organizations needing to stay current on Medicare billing and compliance updates tied to emergency rules.

Article Sections

  1. Expansion of telehealth billing during the PHE

    Overview of temporary CMS changes affecting hospital and physician telehealth billing during the public health emergency. The section discusses facility-based and practitioner-based service delivery settings and related billing considerations.

  2. Hospital billing

    Discussion of hospital outpatient billing for remotely furnished services and related department status considerations. The section also covers billing treatment for relocated provider-based departments and originating site payment concepts.

  3. Physician billing

    Summary of temporary telehealth policy changes affecting practitioner eligibility, communication methods, and payment updates. This section focuses on Medicare telehealth billing changes during the emergency period.

  4. Increased diagnostic testing

    Overview of CMS changes related to COVID-19 diagnostic testing coverage and specimen collection during the public health emergency. The section also addresses related laboratory testing and outpatient testing workflow impacts.

What You Will Learn

  • How CMS temporarily changed hospital and physician telehealth billing during the COVID-19 public health emergency
  • Which types of providers and services were addressed in the telehealth guidance
  • How CMS updated coverage policy for COVID-19 and related diagnostic testing
  • What the article covers about hospital outpatient specimen collection and testing-related billing
  • Why temporary emergency rules matter for Medicare billing operations

Who Should Read This

  • Hospital revenue cycle staff
  • Physician billing and coding professionals
  • Compliance teams
  • Medicare billing specialists
  • Healthcare administrators

Codes Discussed

  • HCPCS Level II: Q3014
  • HCPCS Level II: C9803
  • CPT: 99211

Modifiers Discussed

  • HCPCS Level II: -PO
  • HCPCS Level II: -PN

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