CMS publishes updated billing guidance on COVID-19 testing counseling

Organizations may bill Medicare for isolation and quarantine counseling provided to patients being tested for the novel coronavirus (COVID-19), according to an update to MLN Matters SE20011.

Advising patients awaiting COVID-19 test results, regardless of whether they show symptoms, on how to properly isolate and quarantine is a key strategy in slowing the spread of the virus. Modeling shows that isolating patients earlier, even by one or two days, can reduce transmission by up to 86%. Physicians and other practitioners are ideally positioned to counsel patients on isolation and quarantine and could help speed referrals for contact tracing, according to the article.

During counseling, physicians and other practitioners can discuss the:

• Signs and symptoms of COVID-19
• Immediate need to separate from others by isolating and quarantining while awaiting test results and after receiving a positive test result
• Importance of informing close contacts of the patient being tested to remain separated while the patient is awaiting test results
• Services that may be available to help the patient successfully isolate or quarantine at home

Patients should also be informed that if they test positive, they will be contacted by the public health department so that contact tracing may begin. Patients should be counseled on the importance of contact tracing and what questions they will be asked, and they should be encouraged to speak to the public health department.

Support services available to help patients isolate and quarantine may vary by location. Organizations, physicians, and other practitioners may refer to state and local resources and the CDC’s guidance.

Physicians and other practitioners who furnish these counseling services during a medical visit should use existing coding and payment policies to report services, including evaluation and management visits. When providing COVID-19 testing counseling during 2020, physicians and other practitioners should use time to select the level of visit reported if:

• More than 50% of the face-to-face time for non-inpatient services was spent providing counseling or care coordination
• More than 50% of floor time for inpatient services was spent providing counseling or care coordination

The article also includes links to the following documents:

• Provider counseling Q&A
• Provider counseling talking points
• Provider counseling check list
• Handout for patients to take home

Organizations should ensure revenue cycle staff, physicians, and other practitioners are aware of the updated guidance.