Updated October 17th, 2022
Department of Health and Human Services (HHS) once again renewed the public health emergency (PHE) for COVID-19. Effective October 13th, 2022, the declaration lasts for the duration of the emergency or 90 days (January 11, 2023) but may be extended again by the Secretary. Congress must be notified of the declaration within 48 hours, and relevant agencies, including the Department of Homeland Security, Department of Justice, and Federal Bureau of Investigation, must be kept informed.
CMS is still planning to give 60 days’ notice of termination — which it can do at any time — however they continue to encourage providers to prepare for the end of regulatory flexibilities as soon as possible.
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
BCBS of AL – Updated/New COVID Vaccines
- BCBS of AL Vaccine Information Webpage
- ADPH Vaccination Provider Support
- CDC Vaccine Clinical Resources
- FDA Vaccine Information
- CDC COVID Booster Shots: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html
November 22nd, 2021 – All Adults Now Eligible for COVID-19 Booster Shots
November 4th, 2022 – Biden administration releases COVID-19 vaccine mandates
October 29th, 2021 – https://www.cdc.gov/media/releases/2021/p1021-covid-booster.html
August 24, 2021 – Full FDA Approval for Pfizer-BioNTech COVID-19 Vaccine
After detailed review of clinical trials, the FDA advises that the Pfizer-BioNTech vaccine is safe and effective in preventing serious illness caused by COVID-19, and is fully approved for ages 16 and older.
Emergency use authorization continues for those ages 12 to 15, as well as an additional dose for select immunocompromised individuals.
Update August 20th, 2021 – Third-Dose Vaccine Codes Added for Pfizer, Moderna
BCBS of AL has updated their COVID-19 Vaccines page with the codes for third-dose administration of the Pfizer-BioNTech and Moderna vaccines effective August 13, 2021.
Update August 17, 2021 – COVID-19 Vaccines Additional Doses: Codes & Payment
Update August 4, 2021 – NEW provisional CPT administrative code for potential third dose of Pfizer vaccine
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.
Hear what a MediSYS Provider has to say about the COVID Vaccine: ‘I had my COVID-19 vaccine’ | Letters | dothaneagle.com
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
Update December 7th, 2021 – Claims Update for Vaccines and Monoclonal Antibodies
Effective January 1, 2022, providers who give COVID-19 vaccinations or administer monoclonal antibody treatment to patients enrolled in a Medicare Advantage plan, including Blue Advantage®, should submit claims to the Medicare Advantage plan.
Starting in 2022, Medicare Advantage Organizations (MAOs) and Medicare-Medicaid Plans (MMPs) must pay for the COVID-19 vaccine and its administration (including approved booster doses) without cost sharing for beneficiaries enrolled in their plans, which includes Blue Advantage.
This update also applies to the therapies and administration of monoclonal antibody treatments for patients enrolled in a Medicare Advantage Plan, including Blue Advantage.
BCBS of AL has updated their COVID-19 Vaccine page with newly added codes related to vaccines authorized for use. Refer to this webpage for a list of current vaccine codes and other vaccination-related information.
Click here to see How to View BCBS of AL COVID-19 and Telehealth Benefits on ProviderAccess.
- ALERT: COVID-19 Emergency Expiration Date Extended to January 31, 2022
Subscribe to Medicaid’s texting service to receive immediate text messages regarding to the COVID-19.
- Alabama Medicaid’s Provider Texting Service Instructions
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
Update August 26th, 2021 –
- Impact of the PHE on Telehealth: Comparative Billing Report in August
- COVID-19 Monoclonal Antibody EUA Updates: Casirivimab & Imdevimab
Update August 24, 2021 – CMS Expands Medicare Payments for At-Home COVID-19 Vaccinations
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
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.
Tues, July 20, 2021 Update –The national public health emergency has been extended from July 19, 2021 to Oct. 17, 2021. Below is an overview of how that extension affects temporary provisions for COVID-19 testing and testing-related visits.
- Individual Exchange, Individual and Group Market health plans: From Feb. 4, 2020 through the national public health emergency period, UnitedHealthcare is waiving cost sharing for in-network and out-of-network COVID-19 tests and testing-related visits.
- Medicare Advantage: From Feb. 4, 2020 through the national public health emergency period, UnitedHealthcare is waiving cost sharing for in-network and out-of-network tests for COVID-19, including testing-related telehealth visits.
- Medicaid: State-specific rules and other state regulations may apply. For Medicaid and other state-specific regulations, please refer to your state-specific website or your state’s UnitedHealthcare Community Plan website, if applicable.
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.