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REIMBURSEMENT

Your office will be paid for counselling patients to self-isolate at time of COVID-19 testing

CMS and the Centers for Disease Control and Prevention (CDC) have announced that payment is available to physicians and health care providers to counsel patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to the onset of symptoms.

The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic, and asymptomatic individuals. Education on self-isolation is important as the spread of the virus can be reduced significantly by having patients isolated earlier while waiting for test results or symptom onset. The CDC models show that when individuals who are tested for the virus are separated from others and placed in quarantine there can be up to an 86 percent reduction in the transmission of the virus, compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise.

Provider counseling to patients at the time of their COVID-19 testing will include the discussion of immediate need for isolation, even before results are available, the importance of informing members of their immediate household that they too should be tested for COVID-19, and the review of signs and symptoms and services available to them to aid in isolating at home. In addition, they will be counseled that if they test positive:

  • They should wear a mask at all times
  • They will be contacted by public health authorities and asked to provide information for contact tracing
  • They need to tell their immediate household and recent contacts in case it is appropriate for these individuals to be tested for the virus and to self-isolate as well.

CMS will use existing evaluation and management payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals, and community drive-through or pharmacy testing sites.

More information is available at these links:

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