The Centers for Medicare & Medicaid Services (CMS) to Limit the Use of CS Modifier

On March 18, 2020, The Families First Coronavirus Response Act was signed into law. Section 102, Waiving Cost Sharing Under the Medicare Program for Certain Visits Relating to Testing for COVID-19, requires Medicare Part B to cover beneficiary cost-sharing for provider visits during which a COVID-19 diagnostic test is administered or ordered.
 
Within 10 business day, CMS requires Part B Medicare Administrative Contractors (MACs) to implement edits to limit the use of the CS modifier, waiving cost-sharing to certain CPT/HCPCS codes. CMS will provide national messaging regarding this directive at a later date.
 
Impact to Providers
Editing will reject claims containing the modifier CS on any services other than those identified by CMS and listed below. Claim rejections will appear on remittance advice with claim adjustment reason code, (CARC) 4 and Reason and Remark Code, (RARC) MA130. Rejected claims must be corrected and resubmitted as new claims. When brought to our attention through the claim reopening process, Palmetto GBA will reprocess any claims for services on the attached list with a date of service on or after March 18, 2020, through the date of the end of the Public Health Emergency (when announced), to allow services that were not submitted with the CS modifier to be adjusted so that cost-sharing is not applied. MACs are not being instructed to reprocess claim for other services submitted with the CS modifier prior to the edit implementation. 

99091
99281
99328
99442
99473
99499
G0426
G9481
99201
99281
99334
99443
99474
G0076
G0427
G9482
99202
99282
99335
99446
99475
G0077
G0438
G9483
99203
99282
99336
99447
99476
G0078
G0439
G9484
99204
99283
99337
99448
99477
G0079
G0508
G9485
99205
99283
99341
99449
99478
G0080
G0509
G9486
99211
99284
99342
99451
99479
G0081
G0513
G9487
99212
99284
99343
99452
99480
G0082
G0514
G9488
99213
99285
99344
99453
99483
G0083
G2001
G9489
99214
99285
99345
99454
99483
G0084
G2002
G9685
99215
99291
99347
99455
99484
G0085
G2003
G9978
99217
99292
99348
99456
99487
G0245
G2004
G9979
99218
99304
99349
99457
99489
G0246
G2005
G9980
99219
99305
99350
99458
99490
G0247
G2006
G9981
99220
99306
99354
99460
99491
G0248
G2007
G9982
99221
99307
99355
99461
99492
G0249
G2008
G9983
99222
99308
99356
99462
99493
G0250
G2009
G9984
99223
99309
99357
99463
99494
G0268
G2010
G9985
99224
99310
99358
99464
99495
G0296
G2012
G9986
99225
99315
99359
99465
99495
G0372
G2013
G9987
99226
99316
99406
99466
99495
G0406
G2061
Q3014
99231
99318
99407
99467
99496
G0407
G2062
 
99232
99324
99421
99468
99496
G0408
G2063
 
99233
99325
99422
99469
99496
G0420
G2082
 
99238
99326
99423
99471
99497
G0421
G2083
 
99239
99327
99441
99472
99498
G0425
G9156