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Analysis

CMS, CDC Create Provider Payment for COVID-19 Counseling

By John Commins  
   July 30, 2020

Eligible providers can bill CMS for counseling services regardless of the testing venue, including doctors' offices, urgent care clinics, drive-thrus, or pharmacy testing sites.

Physicians and other healthcare providers will now be paid to counsel patients about the importance of self-isolation after testing for COVID-19, even before test results are known, the Centers for Medicare and Medicaid Services  and the Centers for Disease Control and Prevention announced Thursday.

CMS said it will use existing evaluation and management payment codes to reimburse providers who are eligible to bill CMS for counseling services regardless of the testing venue, including doctors' offices, urgent care clinics, hospitals and community drive-thru or pharmacy testing sites.

COVID-19 can be transmitted by both symptomatic, pre-symptomatic and asymptomatic people, and CDC said educating people about the need for self-isolation can reduced the spread of the virus significantly.

CDC models show that when people who are tested for the virus are separated from others and placed in quarantine, there can be up to an 86% reduction in the transmission of the virus compared to a 40% decrease in viral transmission if the person isolates after symptoms arise.

Providers billing CMS for COVID-19 consultations will be expected to discuss with patients the immediate need for self-isolation – even before test results are known –  and to review the symptoms of the virus, and understand what services are available for them while in quarantine.

Patients who test positive will be told to wear a mask at all times and expect a follow-up call from public health officials for contact tracing. Patients are also being asked to tell their immediate household and recent contacts to be tested and self-isolate.  

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

CMS said it will use existing evaluation and management payment codes to reimburse eligible providers.

CDC says educating people about the need for self-isolation can reduced the spread of the coronavirus significantly.

Consultations will be expected to explain the immediate need for self-isolation – even before test results are known. 


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