Updated April 1st, 2021
COVID-19 Health Emergency Expiration Date Extended to July 20, 2021
Thank you to all the healthcare providers and staff on the front lines of this crisis! MediSYS is here to support you every step of the way!
- Sometime ago, MediSYS implemented technologies necessary for our staff to continue to provide remote support and assistance to our clients.
- MediSYS remains fully operational and will continue to provide the excellent service and support that our clients have come to expect.
- To allow providers more flexibility, MediSYS provides tools for Telehealth and patient payments via text as well as patient communication tools using PatienTXT and/or select recall.
- 8 Steps to Start Performing Telemedicine Visits to Help Prevent the Spread of COVID-19
COVID-19 Vaccination Information
Update March 15th, 2021 – (From CMS Press Release on March 15th – Biden-Harris Administration Increases Medicare Payment for Life-Saving COVID-19 Vaccine | CMS) CMS is increasing the Medicare payment amount for administering the COVID-19 vaccine. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff. At a time when vaccine supply is growing, CMS is supporting provider efforts to expand capacity and ensure that all Americans can be vaccinated against COVID-19 as soon as possible.
Effective for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines, and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished.
BCBS of Alabama
Due to COVID-19, Blue Cross and Blue Shield of Alabama expanded telehealth services effective March 1, 2020. This expansion of services will continue through the end of the federal public health emergency. CMS is allowing the expansion of telehealth services to include Annual Wellness Visits for Blue Advantage patients.
- BCBS of AL Telehealth Coverage for AWVs
- BCBS of AL COVID-19 Coding Guide
- BCBS of AL Telehealth Billing Guide
March 11, 2021 – Important note about Blue Advantage® members: Providers administering COVID-19 vaccines to Blue Advantage members must submit those claims to the CMS Medicare Administrative Contractor (MAC) for payment.
August 17th, 2020 – COVID-19 Testing Clarification for Return to Work/College
The state of Alabama is providing testing free of charge to students through GuideSafe Entry Testing, which is being funded through Federal CARES Act funds allocated by Governor Ivey. COVID-19 testing is required for many public or private four-year colleges in the state of Alabama and for all two-year college for students who reside on campus. For other schools, COVID-19 testing is strongly encouraged but not required. Specific testing protocols are directed by each campus. All students should receive an email explaining the program and the procedure to follow in order to register for testing for a day and time at a location most convenient to them. Students must follow the guidelines and register through the web link provided in the email in order for testing to be covered.
To clarify, BCBS of AL coverage for COVID-19 Testing is as outlined below:
- Medically Appropriate COVID-19 Testing – Testing to detect or diagnose COVID-19 in an individual when there is presence of a potential COVID-19 symptom or actual or suspected exposure to a person with COVID-19.
- Surveillance COVID-19 Testing – Testing for patients to return to work or school to rule out the possibility of COVID-19 in the absence of symptoms or exposure. Federal government guidance on this legislation issued June 23, 2020, states that group health plans and insurers are not required to pay for COVID-19 tests that are ordered for surveillance purposes. This is covered for students through the GuideSafe Entry Testing Program. This is not covered for employees returning to work.
July 31 , 2020 – BCBS AL Updates
- Codes for Telehealth E/M Services – Providers must use correct codes to indicate whether audio and video equipment or audio only was used when performing evaluation and management (E/M) services via telehealth for Blue Advantage® patients. See our Telehealth Coverage Guidelines for more information.
- CPT code 99211 – We’ve added to the list of approved codes related to specimen collection on our COVID-19 Testing page.
- CPT code 87426 – We’ve added this COVID-19 Testing code to the Preferred Medical Doctor (PMD) Agreement – Exhibit I (Physician In-Office Laboratory Procedures).
- Oxygen Therapy – The suspension of the oxygen saturation requirement for both certification and recertification has been extended to September 1, 2020. See our COVID-19 Treatment page for more information.
- Dispensing Limits Discontinued – Dispensing limits on hydroxychloroquine, chloroquine and azithromycin will be discontinued as of August 1, 2020. For more information, see our COVID-19 Treatment page.
July 16, 2020 – BCBS of AL Important Telehealth Coverage Update
Because benefits can vary depending on a member’s plan, it’s important to always check eligibility and benefits through ProviderAccess or your practice management system to confirm coverage and cost-sharing details.
Click here to see How to View COVID-19 and Telehealth Benefits on ProviderAccess.
Subscribe to Medicaid’s texting service to receive immediate text messages regarding to the COVID-19.
- Alabama Medicaid’s Provider Texting Service Instructions
COVID-19 Emergency Expiration Date Extended to April 30, 2021
CMS / Medicare
- CMS/Medicare Newsroom
- CMS Telemedicine Toolkit
- CMS Latest Updates
- CMS letter to clinicians including information about telehealth and virtual visits, accelerated and advanced payments, and recent waiver information.
- Medicare Advanced Payments Fact Sheet
Hear what a MediSYS Provider has to say about the COVID Vaccine: ‘I had my COVID-19 vaccine’ | Letters | dothaneagle.com
December 18th, 2020 – COVID-19 Vaccine Codes: Updated Effective Date for Moderna – During the COVID-19 Public Health Emergency (PHE), Medicare will cover and pay for the administration of the vaccine (when furnished consistent with the EUA). Review the CMS updated payment and HCPCS Level I CPT code structure for specific COVID-19 vaccine information. Only bill for the vaccine administration codes when you submit claims to Medicare; don’t include the vaccine product codes when the vaccines are free.
Oct. 15th, 2020 – CMS expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE). CMS has added 11 new services to the Medicare telehealth services list. Click here to see the list: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes
Oct. 8, 2020 – HHS renewed the COVID-19 public health emergency, effective Oct. 23, 2020, which means that all current Medicare telehealth waivers and other flexibilities are also extended. The renewed pubic health emergency declaration will terminate 90 days thereafter, on Jan. 21, 2021, unless it is renewed again.
Aug 4, 2020 – Telehealth Procedure Codes and Skilled Nursing Facility Consolidated Billing Edits https://www.palmettogba.com/palmetto/providers.nsf/ls/JJ%20Part%20B~BS5PSS1548?opendocument
Update: CMS and the Assistant Secretary of Preparedness and Response (ASPR) released a new toolkit to help state and local healthcare decision makers maximize workforce flexibilities when confronting 2019 Novel Coronavirus (COVID-19) in their communities. To view the COVID-19 Healthcare Workforce Toolkit, visit: https://asprtracie.hhs.gov/Workforce-Virtual-Toolkit
UPDATE: CMS Delays Interoperability Final Rule Roll Out Due to COVID-19. Due to concerns over the coronavirus, CMS had pushed back the deadline for meeting the requirements of the recent Interoperability and Patient Access final rule. For more information visit: https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index
CMS Adds New COVID-19 Clinical Trials Improvement Activity to the Quality Payment Program: Clinicians may now earn credit in the Merit-based Incentive Payment System (MIPS) for participation in a clinical trial and reporting clinical information by attesting to the new COVID-19 Clinical Trials improvement activity. CMS added a new high weighted improvement activity to the 2020 QPP Improvement Activities Inventory that promotes participation in COVID-19 clinical trials and clinical reporting for COVID-19 related care.
Dec. 18, 2020 Update – Temporary Cost Share Waivers, Temporary Prior Authorization Suspensions and Updated Telehealth Policies
- UnitedHealthcare is temporarily suspending select prior authorization requirements for in-network hospitals and in-network Skilled Nursing Facilities (SNFs) nationwide, effective Dec. 18, 2020 through Jan. 8, 2021.
- Individual and Group Market health plans: Beginning Jan. 1, 2021 through Jan. 31, 2021, we will waive cost sharing (copay, coinsurance and deductible) for inpatient COVID-19 treatment at in-network facilities. This includes UnitedHealthcare Individual Exchange health plans. Implementation for self-funded customers may vary.
- Medicare Advantage: Cost sharing (copay, coinsurance and deductible) will be waived for in-network and out-of-network COVID-19 treatment, including inpatient and outpatient treatment, from Feb. 4, 2020 through Jan. 31, 2021. The cost share waivers were previously set to expire on Dec. 31, 2020.
Effective Jan. 1, 2021, certain UnitedHealthcare Medicare Advantage and commercial plans will allow certain Centers for Medicare & Medicaid (CMS)-eligible telehealth services when billed with the member’s home as an originating site.
For important information on changes to UnitedHealthcare’s commercial Telehealth and Telemedicine Reimbursement Policy, UnitedHealthcare Commercial Reimbursement Policy Update Bulletin: October.
For more info visit: https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19.html
Humana: Coronavirus Updates
Rural Health Providers
July 15 – Rural Health Clinic (RHC) COVID-19 Updates
Per CMS Publication 100-02, Chapter 13 (PDF, 400 KB), Section 80.4, productivity standards require 4,200 visits per physician and 2,100 visits per practitioner. If you are having difficulty meeting productivity standards as a result of COVID-19 PHE, you may request an exception to the productivity standards.
The following information is required:
- Visit count that you are requesting as an exception to the standard of 4,200 for physicians and 2,100 for mid-level practitioners
- Documentation to justify an exception to the standard
A separate request is required for each facility/clinic, and they may ask for additional information after receipt of the request.
COVID-19: New and Expanded Flexibilities for RHCs & FQHCs during the Public Health Emergency
On July 6, CMS updated MLN Matters Article SE20016 to clarify how Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can apply the Cost Sharing (CS) modifier to preventive services furnished via telehealth. Click here for more information from CMS.
US Dept. of Health & Human Services (HHS)
The Department of Health & Human Services (HHS) reopened the Provider Relief Fund (PRF) General Distribution portal for certain providers and extended the application deadline to Sept. 13, 2020. The portal is reopened for providers who:
- Did not receive an initial payment that totals approximately 2 percent of their annual patient revenue
- Received an initial payment, but missed the June 3 deadline to submit their revenue information for additional funds
- Were ineligible for prior General Distribution funds due to a change in ownership and did not have Medicare fee-for-service revenue in 2019 OR
- Previously received Phase 1 General Distribution payment(s), but rejected and returned the funds and are now interested in reapplying.
For more information please visit: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html.