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June 04, 2020

CMS Releases FAQ Clarifying Billing and Other Policies During COVID-19

CMS continues to amend and update its lengthy guidance on Medicare Fee for Service Billing as it relates to the COVID-19 pandemic.

On May 27, CMS added language that addresses questions regarding the CARES Act and how it affects the Inpatient Prospective Payment System (IPPS). The update included information on how discharges for individuals with COVID-19 should be identified, including different diagnosis codes for discharges between January 27 and March 31, and for discharges occurring on or after April 1 through the duration of the public health emergency period. CMS also clarified that Section 3710 of the CARES Act “directs the Secretary to increase the IPPS weighting factor of the assigned diagnosis-related group by 20 percent” for diagnosed COVID-19 patients discharged during the public health emergency period.

In the most recent update on June 2, CMS added or revised nine new provisions to the guidance contained in the FAQ. The revisions include clarifications regarding national coverage determinations and when telehealth may satisfy certain face-to-face requirements. CMS stated that as it continues to thoroughly assess the CARES Act, new and revised guidance will be released as implementation plans are announced; therefore, additional updates from CMS are expected. Providers should carefully monitor the guidance contained on the COVID-19 FAQ page to evaluate the impact of new guidance on facility operations and finances.