CMS releases updated COVID-19 billing and coding FAQs

CMS updated its novel coronavirus (COVID-19) billing and coding FAQs on April 9 to reflect recent legislation, new waivers, and emergency rules. The new and updated FAQs address payment for specimen collection, diagnostic laboratory services, and hospital services including temporary expansion sites.

Independent laboratories will be paid for specimen collection from beneficiaries who are homebound or inpatients not in a hospital under certain circumstances. This includes a specimen collection fee and fees for transportation and personnel expenses. The nominal specimen collection fee for COVID-19 testing for homebound and nonhospital inpatients is $23.46.

Hospital-temporary-expansion sites are considered provider-based; however, CMS has waived the provider-based requirements at 413.65 and there are no additional enrollment requirements for temporary expansion sites. Excepted provider-based departments may continue to bill with modifier -PO and nonexcepted provider-based departments should continue to bill with modifier -PN.

Hospitals may begin billing for services provided in their surge locations or expansion sites under their existing CMS certification number. No additional enrollment actions are required.

Ambulatory surgical centers (ASC) may provider hospital inpatient services under arrangement for a hospital or they may become provider-based to a hospital. If an ASC enrolls as a hospital it must function as a hospital providing inpatient and outpatient services and follow any hospital Conditions of Participation that have not been waived. ASCs that enroll as hospitals will not be required to submit a full Medicare cost report. ACSs that do not offer hospital services under arrangement or do not enroll as a hospital themselves may only offer services on the ASC covered procedures list.

The FAQ also addresses questions specific to rural health clinics and federally qualified health centers, telehealth services, and more.