Federal reimbursement available for counseling patients to isolate

July 31, 2020

The Centers for Medicare & Medicaid Services (CMS) plans to reimburse healthcare providers for the time they spend counseling patients suspected of having COVID-19 about the importance of self-isolation, the agency said in a press release.

In a separate announcement, the agency said it added new treatment codes for COVID-19 to the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS).

CMS said the counseling sessions, which should occur at the time a test for COVID-19 is administered, should include a discussion with patients about the need for:

·        Immediate isolation, even before results are available

·         Informing their immediate household and recent contacts that they also should be tested for COVID-19

·         Wearing a mask at all times if they test positive

In addition, providers should review the signs and symptoms of COVID-19 and inform their patients that they will be contacted by public health officials and asked to provide contact tracing information.

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.

Models from the Centers for Disease Control and Prevention (CDC) show that when individuals who are tested for the virus are separated from others and placed in quarantine, there can be up to an 86 percent reduction in the transmission of the virus, compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise.

As far as COVID-19 therapies, CMS added ICD-10 PCS codes for such treatments as the use of remdesivir and convalescent plasma. These new codes, which go into effect August 1, will enable CMS to conduct real-time surveillance and obtain real-world evidence about the effectiveness of these treatments, the agency said.

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