Several updates of interest have been issued since last week’s ISMA COVID-19 Update, including one from UnitedHealthcare (UHC) stating that the national public health emergency (PHE) for COVID-19 ends July 24, 2020.
It is unclear why United Healthcare is stating this, according to ISMA billing and coding consultant Carol Hoppe, CPC, CCS-P, CPC-I. The Centers for Medicare and Medicaid Services (CMS) stated Thursday, June 4, on its regular call with Chicago regional medical associations that no PHE end date has been set, Hoppe said. She also said that CMS indicated it will implement a transition plan and give providers advance notice once an end date has been determined.
Indiana Health Coverage Programs (IHCP) Bulletin BR202022
, issued June 2, also makes clear that no end date for the PHE has been set.
On June, 1, UnitedHealthcare sent the following update on telehealth, prior authorization, COVID-19 related billing and other topics.
Although the national public health emergency period currently has an end date of July 24, 2020, we know your work is far from over. The following resources will help you quickly reference the effective dates for UnitedHealthcare’s temporary benefit, program and procedure changes related to COVID-19, as well as billing guidelines for services such as COVID-19 testing, treatment and telehealth.
Program Date Summary
Our Summary of COVID-19 Dates by Program
outlines the beginning and end dates of program, process or procedure changes that UnitedHealthcare implemented as a result of COVID-19. Full details of these changes, including applicable benefit plans and service information, can be found online
. Please be aware of the following key dates:
- June 1 – All currently effective prior authorization requirements and site of service reviews resume.
- June 30 – Claims with a date of service on or after Jan. 1, 2020 will not be denied for timely filing if submitted by June 30, 2020.
- July 24 – COVID-19 telehealth service coverage and related cost-share waivers for Individual and fully insured Group Market health plan members are extended through July 24, 2020. We’ll adhere to state regulations for Medicaid plans.
- Sept. 30 – Cost share is waived for Medicare Advantage members for both primary and specialty office care visits, including telehealth, through Sept. 30, 2020.
To help you understand how UnitedHealthcare will reimburse services during the national public health emergency period, please download the COVID-19 Provider Billing Guidance
. It outlines billing codes and modifiers. Because guidance may change, please check regularly for updates.
Other Key Reminders
- Mental Health Resources for Health Care Professionals: Resources and support are available to help you focus on, manage and understand your mental and physical well-being during this challenging time.
- HouseCalls and Optum at Home Visits: These visits resumed in some markets on May 22, 2020. We are continuing virtual visits in other markets and will continue to evaluate and resume in-person visits where possible.
- Antibody Test Registration: We’re asking all laboratories and health care professionals who perform COVID-19 antibody tests to register the tests they use. The registration takes only a few minutes to complete.
CMS updates FAQs on fee-for-service billing
CMS has issued updated Frequently Asked Questions (FAQs)
on telehealth. These cover recent COVID-19-related waivers to help physicians, hospitals and rural health clinics. There are also answers on outpatient therapy, appropriate coding and more.
The CMS FAQs has updated information for FQHCs and RHCs,
but answers many other questions about billing for telehealth during the pandemic that apply to everyone.
Once again, CMS has stated that these policy changes are in effect until the end of the declared PHE. What happens after that has not yet been published.