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COVID-19: Practice Management

PRACTICE MANAGEMENT RESOURCES

Joint Statement of the Critical Care Societies Collaborative on the Distribution of Personal Protective Equipment and Allocation of Other Resources

Published November 23, 2020
The Critical Care Societies Collaborative—which includes CHEST, the American Association of Critical‐Care Nurses, the American Thoracic Society, and the Society of Critical Care Medicine—issued a statement to the Trump administration, President-Elect Biden's COVID-19 Task Force, congressional leadership, and state governors regarding the urgent need for a national plan to respond to rising cases of COVID-19. The plan must ensure that frontline health-care workers have appropriate personal protective equipment, address the equitable allocation of resources such as ventilators and medications, and reiterate an unwavering commitment to basic public health measures such as testing, contact tracing, mask use, social distancing, and handwashing.


CHEST Urges Reversal of Proposed Critical Care Reimbursement Cuts Amid Pandemic

Published October 5, 2020
In a comment letter to the Centers for Medicare & Medicaid Services regarding the 2021 Medicare Physician Fee Schedule, CHEST and the American Thoracic Society asked the agency not to move forward with a proposal to cut reimbursement for critical care services by 8%. The letter notes that a payment reduction to critical care providers in the middle of a COVID-19 pandemic that has pushed the specialty to its limits is both emotionally demoralizing and financially challenging. The societies also commented on coverage and payment for telehealth services.


CMS and CDC Announce Provider Payments for COVID-19 Patient Counseling

Published July 30, 2020
The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control & Prevention have announced that payment is available for physicians and health-care providers to counsel patients, at the time of COVID-19 testing, about the importance of self-isolation after they are tested and prior to the onset of symptoms.

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. Review the CMS checklist for more information.


Medicare Fee-for-Service Response to COVID-19 Public Health Emergency

Published June 19, 2020
In light of the public health emergency due to COVID-19, the Centers for Medicare & Medicaid Services (CMS) has issued blanket waivers for many requirements impacting providers who bill Medicare Fee-For-Service (FFS). Providers do not need to apply for individual waivers if a blanket waiver is issued. CMS also published a detailed document with frequently asked questions and answers about Medicare FFS billing during the COVID-19 pandemic.


CPT® Code and Description

Published March 25, 2020
The resources below provide important information COVID-19 related CPT® codes and descriptions. The new coding guidelines are effective immediately and will be standard across the US health system. ICD-10-CM coding guidelines for encounters related to coronavirus are also available. Check the American Medical Association for updated information related to flexible CMS and regulatory flexibility during COVID 19.


Medicare Telehealth Expanded Coverage

Published March 17, 2020
Through the Centers for Medicare & Medicaid Services (CMS), the Trump Administration has announced the expansion of Medicare telehealth coverage, effective March 6, 2020. Included below is an important fact sheet and FAQs regarding this expanded coverage.


For more information on the expansion of telehealth services, please review the below guidelines put together by CHEST's Joint Clinical Practice Committee.


CMS Issues Interim Final Rule

Published April 30, 2020
On Thursday, April 30, 2020, CMS released a new Interim Final Rule. During the COVID-19 Public Health Emergency, the Interim Final Rule makes several new, important temporary changes to Medicare regulations and payments. One important change retroactively (to March 1, 2020) increased payments for telephone-only visits to established patients:

  • CPT 99441: a 5- to 10-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99212, about $46 (99441 is usually reimbursed at about $14).
  • CPT 99442: an 11- to 20-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99213, about $76 (99442 is usually reimbursed at about $28).
  • CPT 99443: a 21- to 30-minute telephone visit, in lieu of a face-to-face office visit, will be reimbursed at a similar rate to a 99212, about $110 (99443 is usually reimbursed at about $41).

These telephone codes may be used when addressing a new or old problem for established patients, and the time accrued includes the billing provider total time throughout a 7-day period, including review of chart, records, images; and communicating with the patient. There should not be another patient encounter for 7 calendar days before or after the telephone visit.

In addition, the new Interim Final Rule now allows attending physicians at teaching institutions providing supervision to report for telephone (using 99441-99443) or video (using 99212-99215) telemedicine encounters by residents, when the supervision is provided immediately after the resident encounter, rather than during the telephone or video visit.

A CMS press release about the rule is available at https://www.cms.gov/newsroom/press-releases/trump-administration-issues-second-round-sweeping-changes-support-us-healthcare-system-during-covid.