Emergencies and Disasters - JE Part B
Emergencies and Disasters
COVID-19
All COVID-19 flexibilities and waivers, except those stated otherwise on this page, will expire after May 11, 2023. Providers will be required to revert to pre-COVID policies on May 12, 2023. Please the CMS Current Emergencies page for information and updates related to COVID-19.
On this page, view the below information.
- Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans
- COVID-19 Vaccine, Monoclonal Antibodies and Administration
- Incident-to
- Telehealth
- COVID-19: Advanced Payment
- Enrollment Guidelines
- Resources
Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans
CMS is issuing a toolkit to help health insurance issuers, and Medicare Advantage plans identify the issues that need to be considered and addressed in order to provide coverage and reimbursement for the COVID-19 vaccine and administration.
COVID-19 Vaccine, Monoclonal Antibodies and Administration
For detailed information on COVID-19 vaccine, monoclonal antibodies, and administration, including CPT and HCPCS coding, pricing, and effective dates, please visit the CMS Vaccine Pricing webpage.
Incident-To
During the COVID-19 PHE CMS temporarily changed the definition of "direct supervision" to allow the supervising health care professional to be immediately available through virtual presence using real-time audio/video technology instead of requiring their physical presence. This flexibility will be extended through December 31, 2023.
Telehealth
Through the Consolidated Appropriations Act (CAA) 2023, CMS has extended the following Telehealth waivers and flexibilities until the end of 2023.
- Services temporarily added to Medicare Telehealth will be available through 2023.
- Providers may continue to use the POS they would have used if rendering the service in person with modifier-95 appended until end of 2023.
CMs has also extended the following flexibilities until the end of 2024:
- Telehealth services may be furnished in any geographic area and originating site (including the patient’s home) until the end of 2024.
- Telehealth services may be furnished by physical therapists, occupational therapists, speech-language pathologists, and audiologists until the end of 2024.
- Delay of the face-to-face requirements for telehealth services through the end of 2024.
COVID-19: Advance Payment
CMS Announces New Repayment Terms for Medicare Loans made to Providers during COVID-19
CMS announced amended terms for payments issued under the Accelerated and Advance Payment Program. Providers were required to make payments starting August of 2020, but with this action, repayment will be delayed until one year after payment was issued.
See CMS Announces New Repayment Terms for Medicare Loans made to Providers during COVID-19 for complete information.
View the CMS COVID-19 Accelerated and Advance Payment (CAAP) Repayment & Recovery Frequently Asked Questions resource for additional information.
Enrollment Guidelines
COVID-19 Hotline Enrollments and Temporary Enrollment
Providers who temporarily enrolled as Medicare a provider for the duration of the COVID PHE will receive notification letters from their MAC granting them the option to become fully enrolled. Providers who do not respond within 90 days of their letter will have their enrollment terminated.
Telehealth
Providers are not required to report their home address if providing telehealth services from their home until the end of 2024.
- If a provider submits a paper/web application and the MAC is able to clearly determine that the application is to add a home address, MAC shall return the application.
- MACs shall note the following as the return reason in the letter "This application is not needed for the transaction in question. Providers are not required to report their home address if providing telehealth services from their home."
Revalidation
- For applications received prior to March 1, 2020, Noridian will not deactivate for non-response to development or revalidation.
- Revalidation due date lists will resume afterwards, consistent with pre-PHE revalidation workloads.
Enrollment of Ambulatory Surgical Centers (ASCs) as Hospitals
When an ASC enrolled as a hospital, their billing privileges as ASCs were terminated once the approval for the hospital enrollment had been established. An ASCs hospital enrollment will terminate upon termination of the COVID PHE. ASCs must submit a notification of intent to convert back to an ASC to the applicable CMS Survey and Operations Group (SOG) location on or before the conclusion of the PHE via email or mailed letter.
If the ASC wishes to participate as a hospital after the PHE has ended, it must submit form CMS-855A to begin the process of enrollment and initial certification as a hospital under the regular processes. An initial survey, either done by the State Agency or Accreditation Organization, will be conducted to determine compliance with all applicable hospital Conditions of Participation.
Resources
In the event of a national or regional catastrophe or disaster, the Emergency Response and Recovery webpage contains information about the most recent emergencies and disasters.
Access the below topic related information from this page.
Access additional resources that may assist providers when handling claims related inquiries from the below.
- CMS FAQs for Provider Enrollment
- Comprehensive Error Rate Testing (CERT) Documentation Requests Impacted by a Disaster
- CR Modifier
- Modifiers Used During the COVID 19 Public Health Emergency (PHE)
