Medicare providers, however, should keep records relating to the use of blanket waivers and should bill related services with appropriate condition codes or modifiers to indicate that the services are subject to a PHE waiver.
A version of this article was first published March 8, 2021, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.
Q: Do we need to submit a formal request to CMS for any of the COVID-19-related waivers to apply? Do we need to keep records or documentation pertaining to which waivers we've used and the services they apply to?
A: Fortunately, most of the Medicare waivers issued in response to COVID-19 are what are referred to as “blanket” waivers.
Blanket waivers apply nationally, beginning with their effective date and continuing through the end of the public health emergency (PHE) (unless otherwise specified) and do not require a formal request.
Medicare providers, however, should keep records relating to the use of blanket waivers and should bill related services with appropriate condition codes or modifiers to indicate that the services are subject to a PHE waiver.
Providers can only take advantage of a Medicare waiver if the provider’s use of the waiver is approved by the state in which the provider is providing services and is consistent with that state’s emergency preparedness plan.
For more information, see "Note from the instructor: Creative delivery of outpatient hospital services during the COVID-19 PHE, Part II" by Judith Kares, JD.
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