Wiki Modifier CS - Cost share waived

[LMsampil]

Hello,

Can anyone shed a light on CMS Modifier CS

CMS now waives cost-sharing (coinsurance and deductible amounts) under Medicare Part B for Medicare patients for certain COVID-19 testing-related services. Previously, CMS made available the CS modifier for the gulf oil spill in 2010; however, CMS recently repurposed the CS modifier for COVID-19 purposes. Now, for services furnished on March 18, 2020, and through the end of the Public Health Emergency, outpatient providers, physicians, and other providers and suppliers that bill Medicare for Part B services under specific payment systems outlined in the April 7 message should use the CS modifier on applicable claim lines to identify the service as subject to the cost-sharing wavier for COVID-19 testing-related services and to get 100% of the Medicare-approved amount. Additionally, they should NOT charge Medicare patients any co-insurance and/or deductible amounts for those services.

Does Modifier CS only applies to visit when covid testing is ordered or administered, or all covid related visits/assessment even when the doctor did not order the test ?

 

[patti66]

I work in hospital setting and were told by our compliance office that the cs modifier shouldn't be used on our admission/rounding codes only on the testing itself


I found this on cms website
https://www.cms.gov/outreach-and-ed...-partnership-email-archive/2020-04-07-mlnc-se
Families First Coronavirus Response Act Waives Coinsurance and Deductibles for Additional COVID-19 Related Services
The Families First Coronavirus Response Act waives cost-sharing under Medicare Part B (coinsurance and deductible amounts) for Medicare patients for COVID-19 testing-related services. These services are medical visits for the HCPCS evaluation and management categories described below when an outpatient provider, physician, or other providers and suppliers that bill Medicare for Part B services orders or administers COVID-19 lab test U0001, U0002, or 87635.
Cost-sharing does not apply for COVID-19 testing-related services, which are medical visits that: are furnished between March 18, 2020 and the end of the Public Health Emergency (PHE); that result in an order for or administration of a COVID-19 test; are related to furnishing or administering such a test or to the evaluation of an individual for purposes of determining the need for such a test; and are in any of the following categories of HCPCS evaluation and management codes:

• Office and other outpatient services
• Hospital observation services
• Emergency department services
• Nursing facility services
• Domiciliary, rest home, or custodial care services
• Home services
• Online digital evaluation and management services

Cost-sharing does not apply to the above medical visit services for which payment is made to:

• Hospital Outpatient Departments paid under the Outpatient Prospective Payment System
• Physicians and other professionals under the Physician Fee Schedule
• Critical Access Hospitals (CAHs)
• Rural Health Clinics (RHCs)
• Federally Qualified Health Centers (FQHCs)