Rapid Fire Q & A
Items in green indicate the newest information available.
- Is CMS changing the way it will reimburse providers for COVID-19 lab tests that utilize high-throughput technology? 21 October 2020
- Has CMS expanded its list of covered professional telehealth services? 15 October 2020
- Has the AMA created new CPT codes for laboratory tests that simultaneously screen for COVID-19, influenza and respiratory syncytial virus? 9 October 2020
- Has CMS decided to delay the recoupment of loans issued under the Accelerated and Advance Payment Program? 1 October 2020
- Has CMS clarified how providers should notify their MAC when submitting inpatient claims for COVID-19 patients who do not have a documented positive COVID-19 lab test in their record? 15 September 2020
- We heard the AMA just created two more COVID specific CPT codes, what are the new codes and how are they used? 9 September 2020
- Has CMS issued any guidance to clarify which CPT and HCPCS codes modifier CS can be applied to? 28 August 2020
- What are the key takeaways for revenue cycle professionals from CMS’ third COVID-19 Interim Final Rule, CMS-3401-IFC, released on August 25, 2020? 27 August 2020
- Does a patient need to have a positive COVID-19 lab test in order for us to receive the additional 20 percent increase of the MS-DRG weighting factor for our Medicare inpatient COVID-19 claims? 18 August 2020
- Has the AMA created new CPT codes related to COVID-19 antibody and virus testing? 13 August 2020
- Has the educational and testing period for the Appropriate Use Criteria Program, which was set to terminate on December 31, 2020, been extended by CMS? 13 August 2020
- 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? 4 August 2020
- Does Remdesivir have an assigned HCPCS code? Should we report Remdesivir using HCPCS code C9399? 3 August 2020
- Will professionals be reimbursed for time spent counseling patients on the importance of isolation and contact tracing during the COVID-19 testing process? 31 July 2020
- 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? 24 July 2020
- Is there a new CPT code to report COVID-19 antigen testing? 29 June 2020
- Are there new data reporting requirements for COVID-19 laboratory testing? 11 June 2020
- Is CMS now allowing hospitals to bill for professional telehealth services directly on a hospital UB04 claim? 4 June 2020
- Has CMS released any information to clarify when we should be using condition code DR or modifier CR? 2 June 2020
- Has CMS published the payment rates for the new COVID-19 antibody laboratory CPT codes 86769 and 86328? Are these codes retroactive for Medicare? 20 May 2020
- If we make a patient’s home a temporary expansion site of our provider-based department (PBD), are we required to only append modifiers PO or PN to items and services that are reimbursed under the Outpatient Prospective Payment System (OPPS) or do these modifiers need to be appended to all claim line items? 18 May 2020
- Will CMS cover COVID-19 antibody lab tests when performed as part of pre-admission testing/screening for surgical patients? 15 May 2020
- Are the new high-throughput diagnostic laboratory HCPCS codes U0003 and U0004 retroactively effective back to March 18, 2020 or April 14, 2020? 14 May 2020
- We heard CMS just approved a new code for hospitals to report COVID-19 laboratory specimen collections. What is the new code, to what date is the code retroactively effective and what is the reimbursement rate? 1 May 2020
- Are we required to publicly post our cash prices for the COVID-19 diagnostic laboratory tests that we offer? 24 April 2020
- What services do we append the “CS” modifier to for Medicare beneficiaries? 22 April 2020 *updated 14 May 2020
- CMS stated it will now reimburse providers $100 for COVID-19 lab tests that utilized “high throughput technologies”, what are some examples of this lab technology and how do we report these kinds of tests on claims? 17 April 2020
- Is there a special payment rate for COVID-19 Medicare inpatients? 16 April 2020
- I heard there are new CPT codes to report COVID-19 antibody testing, what are the new codes and how are they used? 15 April 2020
- I heard we can now provide physical therapy, occupational therapy and speech therapy services through telehealth, is that correct? Are there any restrictions on who can bill Medicare for these services? 7 April 2020
- Can hospitals bill for telehealth services provided by our employed clinicians on the hospital’s UB04 claim form? 6 April 2020 *updated 14 May 2020
- Are the new COVID-19 lab specimen collection HCPCS codes G2023 and G2024 chargeable by all provider types? Can our hospital bill for these codes? 3 April 2020
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