CMS to Pay Clinicians for Counseling Patients During COVID-19 Tests

Alicia Ault

July 30, 2020

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The Centers for Medicare & Medicaid Services (CMS) said it will pay eligible clinicians for telling patients to isolate while awaiting results of a test for the novel coronavirus.

Under the just-announced policy, doctors and other healthcare providers will be able to bill CMS using existing evaluation and management (E/M) payment codes when they discuss with patients the immediate need for isolation, and the importance of informing their immediate household members that they should also be tested for COVID-19.

The agency has provided a checklist for clinicians to use.

Clinicians are also expected to review the signs and symptoms of the disease and discuss services available to patients to help them isolate at home. 

Reimbursement is available regardless of where a test is administered, including doctor's offices, urgent care clinics, hospitals, and community drive-thru or pharmacy testing sites.

If patients test positive, clinicians are expected to counsel patients to wear a mask at all times and to tell them they will be contacted by public health authorities who will be seeking information for contact tracing. Clinicians should also counsel COVID-positive patients to inform their immediate household and recent contacts, as they may also need to be tested and to self-isolate.

Isolation during the potential infectivity period is important, said CMS. It noted that the US Centers for Disease Control and Prevention (CDC) modeling has determined that virus transmission can be reduced by 86% when individuals quarantine while awaiting test results. Isolating after symptoms only reduces transmission by 40%, according to the CDC model.

Alicia Ault is a Lutherville, Maryland-based freelance journalist whose work has appeared in publications including, the New York Times, and the Washington Post. You can find her on Twitter @aliciaault. 

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