California Wildfires

Medicare Response to Wildfires in California - Public Health Emergency (PHE)

A public health emergency (PHE) was announced on January 10, 2025, providing flexibility to support beneficiaries in the State of California, effective date retroactive to January 7, 2025, due to California Wildfires.

During the California PHE, Administrator of the Centers for Medicare & Medicaid Services (CMS) authorized waivers under §1812(f) of the Social Security Act for the state of California for those people who are evacuated, transferred, or otherwise dislocated as a result of the effect of the disaster.

Sections listed in the presidential declaration, and authorized waivers and modifications under §1135 of the Social Security Act are currently in effect and will be valid for 90 days from the effective date of the PHE, unless otherwise notified.

  • Hospitals, Psychiatric Hospitals, including Cancer Centers and Long-Term Care Hospitals (LTCHs)
  • Skilled Nursing Facilities (SNF)
  • Intermediate Care Facility for Individuals with Intellectual Disabilities
  • End Stage Renal Dialysis (ESRD)
  • Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)

Review the 2025 Southern California Wildfire Waivers webpage for details.

Mandatory Use of CR Modifier and DR Condition Code

In accordance with IOM Pub.100-04, Chapter 38 Section 38.10, "CR" modifier (CMS-1500) and the "DR" condition code (UB-04) are mandatory on claims for items and services for which Medicare payment is conditioned on the presence of a "formal waiver" including, but not necessarily limited to, waivers granted under either §1135 or §1812(f) of the Social Security Act.

Provider Enrollment Relief

Noridian will offer provider enrollment relief to providers impacted by the wildfires in Southern California (Los Angeles County). This applies to applications received on or after January 7, 2025, and will remain in effect for a period of 90 days.

  • All off-cycle revalidation due dates for Skilled Nursing Facilities (SNFs) were previously extended and should not be impacted by this new declaration.
  • Allowing retrospective billing privileges of up to 90 days prior to the receipt date of the application or the effective date of the declaration, whichever is later.
  • Temporary changes for providers or suppliers must be submitted via the appropriate CMS-855 application.

Providers and suppliers must resume compliance with normal Medicare fee-for-service rules and regulations as soon as they are able to do so and, in any event, the waivers or modifications a provider and supplier was operating under are no longer available after the termination of the emergency period.

California Wildfire Resources

The Centers for Medicare & Medicaid Services (CMS) has announced additional resources and flexibilities to support beneficiaries during the California wildfires:

For more information, visit the CMS Newsroom.

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