COVID-19: Waive Cost-Sharing for Hospital Outpatient Departments

Published 12/02/2020

The Families First Coronavirus Response Act waives cost-sharing under Medicare Part B (coinsurance and deductible amounts) for COVID-19 testing-related services through the end of the public health emergency. In April, The Centers for Medicare & Medicaid Services (CMS) provided evaluation and management (E/M) categories for applicable medical visits. We are now specifying Healthcare Common Procedure Coding (HCPCS) procedure codes for this cost-sharing waiver for Hospital Outpatient Departments paid under the Outpatient Prospective Payment System (PDF, 167 KB).

Use the Cost Sharing (CS) modifier on applicable claim lines to identify the service as subject to this cost-sharing wavier. If you use the CS modifier with HCPCS codes that are not on the list, we will return the claim.

CMS published the codes applicable to Part B and Part A providers in the COVID-19: Waive Cost-Sharing for These HCPCS Codes in the MLN Matters August 27, 2020, Special Edition.

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