News & Events Archives

We have decided to make a patient’s home a temporary expansion site of our provider-based department. Our provider-based department services are always split-billed; the hospital submits a claim for the technical portion of the service and the physician submits their own claim for the professional portion of the service. When services are rendered virtually, does the rendering physician’s physical location during the service affect whether these visits should be billed as telehealth?

Yes. Within the latest update of their “COVID-19 Frequently Asked Questions on Medicare Fee-for-Service Billing” document, CMS added a new subsection entitled “LL. Hospital Billing for Remote Services”. The new subsection aims to further clarify when remote services...

Does Remdesivir have an assigned HCPCS code? Should we report Remdesivir using HCPCS code C9399?

News & Events

There is currently no HCPCS code for Remdesivir. Assuming all pass-through and other program coverage requirements are met, CMS will typically establish either a temporary or permanent HCPCS code for a new drug product once the product is approved by the Food and Drug...

Will professionals be reimbursed for time spent counseling patients on the importance of isolation and contact tracing during the COVID-19 testing process?

News & Events

Yes. Within their updated MLN Matters Article SE20011, CMS strongly encourages providers to counsel patients on the importance of self-isolation and participation with regards to contact tracing efforts for those patients who are either awaiting COVID-19 laboratory...

Has the COVID-19 Public Health Emergency which was set to expire on July 25, 2020 been extended by the Department of Health and Human Services?

News & Events

Yes. On July 23, 2020 Secretary Alex Azar signed the required documentation to extend the COVID-19 Public Health Emergency for another 90 days. For healthcare providers, this means all waivers and flexibilities granted by CMS which are conditioned on a PHE being...

Is there a new CPT code to report COVID-19 antigen testing?

News & Events

Yes. On June 25, 2020 the AMA announced the creation of new CPT code 87426 to report laboratory antigen testing of patients suspected of being infected with the novel coronavirus (SARS-CoV-2). We have provided the CPT code long descriptor for the newly established...

Are there new data reporting requirements for COVID-19 laboratory testing?

News & Events

Yes. On June 4, 2020 HHS published the press release linked below that outlines the updated laboratory data reporting requirements. Per the press release: “The new reporting requirements will provide information needed to better monitor disease incidence and trends by...