CMS Specifies HCPCS Codes for Services Subject to PHE Cost-Sharing Waivers
In its August 27, 2020 edition of mlnconnects, CMS announced HCPCS codes to use during the Public Health Emergency (PHE) for Medicare Part B claims that are subject to the cost-sharing waivers (coinsurance and deductible amounts) for COVID-19 testing-related services. Specific HCPCS Cost-Sharing (CS) modifiers must be used on applicable claim lines to identify the service as subject to this cost-sharing waiver by the following provider types: Physicians and Non-Physician Practitioners, Hospital Outpatient Departments paid under the Outpatient Prospective Payment System (OPPS), Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs) and Critical Access Hospitals (CAHs). CMS stated that if a provider uses the CS modifier with HCPCS codes that are not on the list, the claim will be returned. On August 26th, CMS also revised page 11 of MLN Matters Special Edition Article SE20011, Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19), to add information about the HCPCS codes and CS modifiers.