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April 17, 2023

CR Modifier for COVID-19 PHE - Revised

On February 9, the Department of Health and Human Services (HHS) announced the Public Health Emergency (PHE) for COVID-19 will end on May, 11, 2023External Website. Since the CR modifier should only be reported during a PHE when a formal waiver is in place, plan to discontinue using it and the COVID-19 narrative for claims with dates of service on or after May 12, 2023. The CR modifier may be required for a different emergency declaration, but not COVID-19.

Since the COVID-19 PHE is ending, CGS is providing the following reminders about the use of the CR modifier. The CR modifier and "COVID-19" narrative should only be appended when all the following apply:

  • Claims for dates of service March 1, 2020-May 11, 2023; and
  • The items provided fall under the scope of a blanket waiver or flexibility listed in the chart in MLN Matters SE20011External PDF.

Find more information on current waivers on the CMS Current Emergencies page.External Website

The DME MACs published information below to further clarify the use of the CR modifier and specific situations outlined in the MLN and the national and local coverage determinations affected:

Reason for reporting CR modifier: DME MAC Requirements/Instructions:
Clinical Indications for Certain Respiratory, Home Anticoagulation Management, Infusion Pump and Therapeutic Continuous Glucose Monitor national and local coverage determinations

Includes:

  • No Oxygen Certification of Medical Necessity (CMN)
  • No External Infusion Pump DME Information Form (DIF)
Face-to-face and in-person requirements for national and local coverage determinations
Signature requirements for proof of delivery
Part B prescription drugs and enteral nutrition refills

Publication History

April 10, 2023 Revised to add the end of the PHE announcement and instructions on when to discontinue using CR modifier and COVID19 narrative.
February 2, 2023 Originally Published

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