Billing & Coding

CMS Issues Reminders for Billing COVID-19 Specimen Collection & Symptom/Exposure Assessment

On June 18, CMS offered up some guidance on billing Medicare for COVID-19 symptom and exposure assessment and specimen collection performed on and after March 1, 2020:

  • Use CPT code 99211 to bill for assessment and collection provided by clinical staff (such as pharmacists) incident to your services, unless you’re reporting another Evaluation and Management (E/M) code for concurrent services;
  • The above guidance on code 99211 applies to all patients, not just established ones;
  • Submit the CS modifier with code 99211 (or other E/M code for assessment and collection) to waive cost sharing;
  • If you didn’t include the CS modifier when you submitted 99211, contact your Medicare Administrative Contractor so it can reopen and reprocess the claim;
  • CMS will automatically reprocess claims billed for code 99211 that it denied due to place of service editing.