IMPORTANT COVID-19 RESOURCES

CMS: COVID-19 Provider Toolkit
CMS: COVID-19 FAQs
CDC: COVID-19 Vaccination Communication Toolkit for medical centers, clinics, and clinicians
FDA: COVID-19 Vaccines webpage

CMS: Because of the COVID-19 pandemic, fewer people are getting vaccines, which puts their communities at greater risk for other preventable diseases. When people with Medicare get the flu shot, it helps protect them and keep them from spreading the flu to others. We have a wealth of information on the CMS resource page, including flu messages and products, at https://www.cms.gov/flu-shot-outreach-media-material.

COVID-19 UPDATES

COVID-19 Vaccine Codes: Updated Effective Date for Pfizer-BioNTech
On December 11, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the Pfizer-BioNTech COVID 19 Vaccine for the prevention of COVID-19 for individuals 16 years of age and older. Review Pfizer’s Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) regarding the limitations of authorized use.

During the COVID-19 Public Health Emergency (PHE), Medicare will cover and pay for the administration of the vaccine (when furnished consistent with the EUA). Review our updated payment and HCPCS Level I CPT code structure for specific COVID-19 vaccine information. Only bill for the vaccine administration codes when you submit claims to Medicare; don’t include the vaccine product codes when vaccines are free.

COVID-19 Vaccine Toolkits
On October 28, 2020, the Centers for Medicare & Medicaid Services (CMS) issued an Interim Final Rule (IFC) with Comment Period (CMS-9912-IFC). The press release contains links to the IFC, the fact sheet, as well as frequently asked questions on billing for therapeutics.

In preparation for the release of the COVID-19 vaccine, CMS has developed COVID-19 vaccine toolkits for insurers, providers, and Medicare beneficiaries in order to convey critical information to all stakeholders in one central location. These toolkits will be updated periodically, as needed, as more information becomes available.

COVID-19 eNews UPDATES 2020-2021

February 12, 2021
Flu Vaccine

February 10, 2021
COVID Vaccines

May 28, 2020
CMS Issues Nursing Home Best Practices Toolkit to Combat COVID-19

May 18, 2020
CMS News Release COVID-19 – IFCS Special Edition

May 11, 2020
Frequently Asked Questions (FAQs) on Emergency Medical Treatment and Labor Act (EMTALA)

May 11, 2020
Trump Administration Issues Second Round

May 11, 2020
Reminder of Flexibilities for Notice Delivery for Beneficiaries Receiving Institutional Care

April 28, 2020
New Toolkit to Help States Navigate COVID-19 Health Workforce Challenges

April 28, 2020
CMS Releases Additional Blanket Waivers

April 15, 2020
Non Emergent Elective Medical Services and Treatment Recommendations

April 15, 2020
CMS Reducing Unnecessary Barriers of Care During COVID-19

March 19, 2020
COVID-19 Cost-Sharing, Prior Authorization’s Waived

March 19, 2020
Expansion of Telehealth with 1135 waiver

March 19, 2020
New Measures to Protect Nursing Home Residents Regarding COVID-19

PROVIDER TELEHEALTH AND TELEMEDICINE TOOL KIT

*The information contained within each toolkit will outline temporary virtual services that could be used to treat patients during this specific period of time.

Effective March 6, 2020
General Provider Telehealth and Telemedicine Tool Kit

Effective March 6, 2020
ESRD Provider Telehealth and Telemedicine Tool Kit

Effective March 6, 2020
Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit

CMS INCREASES MEDICARE PAYMENT FOR HIGH-PRODUCTION CORONAVIRUS LAB TESTS

CMS announced that Medicare will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases. This is another action the Trump Administration is taking to rapidly expand COVID-19 testing. Along with the March 30 announcement that Medicare will pay new specimen collection fees for COVID-19 testing, CMS’s actions will expand capability to test more vulnerable populations, like nursing home patients, quickly and provide results faster. Medicare will pay laboratories for the tests at $100 effective April 14, 2020, through the duration of the COVID-19 national emergency.

Press Release

CMS IMPLEMENTS CARES ACT HOSPITAL PAYMENT AND INPATIENT REHABILITATION FACILITY WAIVERS

The Coronavirus Aid, Relief, and Economic Security (CARES) Act increases payment for Inpatient Prospective Payment System (IPPS) and long-term care hospital (LTCH) inpatient hospital care attributable to COVID-19. CMS provided guidance for IPPS hospitals and LTCHs on how to code claims to receive the higher payment.

The CARES Act also waives the requirement that Medicare Part A fee-for-service patients treated in inpatient rehabilitation facilities receive at least 15 hours of therapy per week.

MLN Connects Article

Emergency Declaration Waivers Summary

CMS APPROVES ADDITIONAL STATE MEDICAID WAIVERS AND AMENDMENTS TO GIVE STATES FLEXIBILITY TO ADDRESS CORONVIRUS PANDEMIC

CMS has approved 52 COVID- related emergency waivers, 31 state amendments, 11 COVID-related Medicaid Disaster Amendments and one CHIP COVID-related Disaster Amendment in record time. States are using a toolkit CMS developed to expedite the application and approval of Medicaid state waivers and State Plan Amendments.

CMS recently approved two additional COVID-related emergency Medicaid waivers, delivering urgent regulatory relief to ensure the Commonwealth of Puerto Rico and the Commonwealth of the Northern Mariana Islands can quickly and effectively care for their most vulnerable citizens. CMS also approved COVID-related Medicaid Disaster Amendments that bring relief to Arkansas and Rhode Island. These approvals help to ensure that states have the tools they need to combat COVID-19 through a wide variety of state plan flexibilities. CMS continues to authorize amendments to ensure emergency flexibilities in programs that care for the elderly and people with disabilities, including most recently for Colorado, Louisiana and Nevada. These approved flexibilities support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.

Section 1135 Waivers

1915(c) Waiver Appendix K Amendments

Medicaid State Plan Amendments

CHIP State Plan Amendments

COVID-19 CODING

Effective February 20, 2020
New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), October 1, 2020

Effective February 20, 2020
ICD-10-CM Official Coding Guidelines – Supplement
Coding encounters related to COVID-19 Coronavirus Outbreak

STAY UP-TO-DATE

To keep up with the important work the Task Force is doing in response to COVID-19 click here www.coronavirus.gov.

For complete and updated information specific to CMS, please visit the Current Emergencies Website.

2019-Novel Coronavirus (COVID-19) Medicare Provider Enrollment Relief Frequently Asked Questions (FAQs).

Coronavirus Updates for State Surveyors and Accrediting Organizations.

CMS NEWSROOM

CMS Letter:  Summary of Actions to Reduce Unnecessary Barriers to Patient Care During COVID-19 Outbreak

Get the most current Press Releases from CMS by going to the CMS Newsroom Homepage

 


ROUTINE UPDATES

April 8, 2021
CMS Announcement: Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension

February 12, 2021
Flu Vaccine

January 26, 2021
UPDATE: Behavioral Health Authorization and Behavioral Health Case Management

January 26, 2021
REMINDER: PAD Timely Filing Guidelines

 

 

Last Modified: April 8, 2021