COVID-19 Diagnostic Laboratory Tests: Billing for Clinician Services

Physicians and non-physician practitioners (NPPs): Here are several reminders from the Centers for Medicare & Medicaid Services (CMS) related to billing 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 are reporting another Evaluation and Management (E/M) code for concurrent services. This applies to all patients, not just established patients.
• Submit the CS modifier with 99211 (or other E/M code for assessment and collection) to waive cost sharing.
• Contact your Medicare administrative contractor if you did not include the CS modifier when you submitted 99211 so they can reopen and reprocess the claim.
• CMS will automatically reprocess claims billed for 99211 that were denied due to place of service editing.