Part B Insider (Multispecialty) Coding Alert

Published on Wed Aug 12, 2020 PDF

Plus: Part B MAC offers insight on Accelerated Payment recoupments.

If your Part B practice is testing patients for the coronavirus and counseling them on self-isolation afterward, you can now bill Medicare for that service.

On July 30, the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) announced reimbursement options for physicians and other healthcare providers who counsel patients after COVID-19 testing on things like self-isolation, review of signs and symptoms, available services, mask wearing, contact tracing, and household testing protocols.

“CMS will use existing evaluation and management (E/M) payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals and community drive-thru or pharmacy testing sites,” advises an agency release.

A counseling checklist is available to make it easier for providers to run through the questions with patients.

View the release and link to the counseling checklist at www.cms.gov/newsroom/press-releases/cms-and-cdc-announce-provider-reimbursement-available-counseling-patients-self-isolate-time-covid-19.

In other news …

Even though the nation is still in the throes of a pandemic, the feds are still forging ahead with recoupment of the Centers for Medicare & Medicaid Services (CMS) Accelerated and Advance Payments (AAPs) for Part B providers.

Reminder: The CMS AAP program started distributing COVID-19 relief funds to struggling Part B providers in April.

Now: In a recent alert, Part B Medicare Administrative Contractor (MAC) NGS Medicare gently reminded providers that CMS has started recoupment proceedings for those funds — and practices should be ready.

“The AAP recoupment process at this time has not changed and is expected to begin on, or about, 7/27/2020, which represents 121 days from the date AAP payments were first issued and will continue for 90 days,” NGS explains. “After those 90 days a demand letter will be sent for any remaining balance. The recoupment date is unique to each provider and is calculated based on the date the AAP was issued.”

The Part B MAC adds, “If a provider cannot pay the balance by the end of the 90 day repayment period they may request an ERS once the demand letter is issued. Since the ERS would then occur beyond the repayment period, interest would be applied at that point.”

Tip: You may want to check in with your specific MAC for recoupment guidance and assistance. All of the MACs offer COVID-19 online help, including webinars, chat opportunities, and more related to repayment of the AAP program funds.