COVID-19 self-isolation counselling reimbursement

The Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention announced that payment is obtainable to physicians and health care providers to counsel patients, at the time of COVID-19 testing, about the importance of self-isolation after they're tested and before the onset of symptoms.

As per the Centers for Disease Control and Prevention (CDC) models when individuals screened for the COVID-19 virus are isolated from others and quarantined without symptoms, the transmission of the virus can be reduced by up to 86 percent compared to a 40 % reduction in viral transmission if the person isolates after symptoms occur.

Counselling services can be billed irrespective of where test is being conducted which may include urgent care centres, outpatient clinics, hospitals, community drive or pharmacy testing sites. Providers need to follow check list issued by CMS which should be included during counselling.

• Discuss the need for immediate isolation, even before results of the test are available.

• Advise patients to inform their immediate household/contacts that they may wish to be tested and quarantine as well. Review locations and people they have been in contact with in the past two weeks.

• Review the signs and symptoms of COVID-19.

• Inform patients that if positive, they will likely be contacted by a public health worker and asked to provide a list of the people they’ve been with for contact tracing, encourage them to ‘answer the call’.

• Discuss services that might help the patient successfully isolate and quarantine at home.

Now we will see CPT codes we can use for billing these services.

99401: Preventive medicine counselling and/or risk factor reduction intervention(s) provided to an individual (separate procedure) approximately 15 minutes.

99402: Preventive medicine counselling and/or risk factor reduction intervention(s) provided to an individual (separate procedure) approximately 30 minutes.

99403: Preventive medicine counselling and/or risk factor reduction intervention(s) provided to an individual (separate procedure) approximately 45 minutes.

99404: Preventive medicine counselling and/or risk factor reduction intervention(s) provided to an individual (separate procedure) approximately 60 minutes.

These codes can be used as standalone code or can be used as additional codes with other E&M codes on the claim form. These codes can also be used for telehealth encounter purpose, check with your respective local insurance provider for billing criteria.

#COVID #Medicare #Reimbursement #Covidtest