Health Law Daily Medicare reimbursement available for counseling patients immediately after COVID-19 test
Friday, July 31, 2020

Medicare reimbursement available for counseling patients immediately after COVID-19 test

By Cathleen Calhoun, J.D.

CMS announces that physicians and health care providers can bill Medicare for counseling on self-isolation before test results are available.

On July 31, 2020, CMS announced that payment is available to health care providers and physicians who counsel patients on self-isolation at time of COVID-19 test and prior to the onset of symptoms. CMS explained the transmission of COVID-19 and the detailed counseling that should be provided.

Transmission. Because COVID-19 transmission occurs from both symptomatic, pre-symptomatic, and asymptomatic people, education on self-isolation could help reduce the spread significantly by having patients isolated earlier, while waiting for test results or symptom onset, according to CMS. CDC models show that when self-quarantine occurs in individuals who are tested for COVID-19, there can be up to an 86 percent reduction in the transmission of the virus. When a person isolates after symptoms arise, there can be up to a 40 percent reduction.

Counseling. At the time of counseling, health care providers and physicians should discuss the immediate need for isolation and the importance of telling household members that they should be tested as well. The counseling should also review the signs and symptoms of COVID-19, as well as the services available to the individuals while they are isolating at home. Also, the individuals should be told that if they test positive: (1) they should wear a mask at all times; (2) they will be contacted by public health authorities and will be asked to provide information for contact tracing purposes; and (3) they should tell their immediate household members and recent contacts since it might be appropriate for them to get tested and self-isolate.

Payment codes. Existing evaluation and management (E/M) payment codes will be used by CMS for reimbursement for those providers who are eligible to bill CMS for counseling services. The counseling services can be provided no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals, and community drive-thru or pharmacy testing sites.

MainStory: TopStory AgencyNews CMSNews BillingNews Covid19 PartBNews

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