• Piyush Kedia

CMS Waives Cost Sharing for Covid diagnosis and treatments

CMS has updated their policies to waive cost sharing waiver for all Covid related medical services. This is retroactive to all claims with Date of Service 03/18/2020 (CMS Link)

As part of the update from Medicare, Cost Sharing is waived for the following categories of visits and providers will be paid the full fee schedule amount

- Medical visits that result in an order for or administration of a COVID-19 test

- Medica Visits that are related to furnishing or administering such a test 

- Medical Visits for purposes of determining the need for such a test

The following categories of HCPCS evaluation and management codes qualify for these waivers

Office and other outpatient services

Hospital observation services

Emergency department services

Nursing facility services

Domiciliary, rest home, or custodial care services 

Home services

Online digital evaluation and management services

How to bill for these services

Use Modifier CS on applicable claim lines to identify the service as subject to the cost-sharing waiver for COVID-19 testing-related services. 

The Best Part

For qualifying claims ALREADY submitted without the CS modifier, you should notify the Medicare Administrative Contractor (MAC) and request to resubmit applicable claims with dates of service on or after 3/18/2020 with the CS modifier to get 100% payment.


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