Medical Billing ServicesRevenue Cycle Management (RCM)

CMS and CDC – Provider Reimbursement Update

The CMS (Centers for Medicare and Medicaid Services) and CDC (Centers for Disease Control and Prevention) recently announced provider reimbursement available to physicians and health care providers to counsel patients, at the time of coronavirus disease 2019 (COVID-19) testing. Providers educate patients about the importance of self-isolation once they are tested and prior to the coronavirus symptoms.

Symptomatic, pre-symptomatic, and asymptomatic individuals emphasize the importance of education on self-isolation as the spread of the virus can be reduced significantly as these patients can transmit COVID-19.

The Centers for Disease Control and Prevention (CDC) models show that when coronavirus patients who tested positive are separated from others and keep them in quarantine will reduce 86 percent reduction in the transmission of the virus.

The Centers for Disease Control and Prevention (CDC) models show that when individuals who are tested for the virus are separated from others and placed in quarantine, there can be up to an 86 percent reduction in the transmission of the virus compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise.

If patients are getting consultation from providers at the time of their COVID-19 testing will include the discussion of immediate need for isolation, even before the results are available. It is important to inform their immediate family that they too should get tested for COVID-19. Review of signs and symptoms of the patient’s family and services available to them to help in isolation at home.

Providers also give basic and important instructions to patients though they test positive or not. Basic instructions like to wear a mask at all times, wash hands regularly, and they will be contacted by public health authorities and asked to provide information for contact tracing and to inform their immediate family and recent contacts in case it is required for these individuals to be tested for the coronavirus and to self-isolate as well.

CMS recently announced the creation of new hospital procedure codes for the use of COVID-19 therapeutics. The agency said over the weekend that it has developed and implemented new procedures codes for the use of remdesivir and convalescent plasma for treating hospitalized COVID-19 patients. The ICD-10-PCS codes went into effect on August 1st, 2020, and can be reported to Medicare and other insurers to identify the use of the treatments by hospital providers.

According to CMS, they will use existing evaluation and management (E/M) payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals, and community drive-thru or pharmacy testing sites.

A new question in CMS’ COVID-19 FAQs clarified that hospitals and other institutional providers cannot bill for telehealth services.

“A hospital may serve as the originating site and can bill for an originating site facility fee for a registered hospital outpatient who is receiving a telehealth service. Billing for telehealth services is distinct from billing for hospital services and other institutional services, and in most circumstances occurs using professional claims, not institutional claims that would be submitted by the hospital or other institutional provider.” CMS stated.

Further information and resource links are available in the Counseling CheckList PDF here: Counseling checklist

We at Medical Billers and Coders catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. The main goal of our organization is to assist physicians in looking for billers and coders. Reach out to our Medical Billing manager today!

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Medical Billers and Coders

Catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. The main goal of our organization is to assist physicians looking for billers and coders, at the same time help billing specialists looking for jobs, reach the right place.

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