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COVID-19

Ending the COVID-19 PHE Resources

The federal Public Health Emergency (PHE) for COVID-19 expired at the end of the day on May 11, 2023.

During the PHE, CMS used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure easier access to care for health care providers and their beneficiaries. Some of the flexibilities created during the pandemic were expanded by the Consolidated Appropriations Act, 2023. Others, while critical during initial responses to COVID-19, are no longer needed.

CMS updated useful information for providers – specifically around major telehealth and individual waivers – initiated during the PHE.

Please refer to the following resources for the most up-to-date information.

COVID-19 Topics

Accelerated/Advance Payment

On March 28, 2020, CMS expanded the Accelerated and Advance Payment Program during the COVID-19 public health emergency to extend financial hardship relief to impacted Medicare Part A Providers, and Part B Providers/Suppliers. On April 26, 2020, CMS announced a reevaluation of the program; it was paused April 27, 2020. Please refer to the April 27, 2020, Special Edition MLN Connects "COVID-19: CMS Reevaluates Accelerated Payment Program and Suspends Advance Payment ProgramExternal PDF" for additional information.

Although paused, CMS continued to accept application until October 8, 2020.

At that time, CMS announced new repayment terms for Medicare loans made during the PHE. Please refer to the October 8, 2020, Special Edition MLN Connects, "CMS Announces New Repayment Terms for Medicare Loans made to Providers during COVID-19External PDF" for additional information.

COVID-19 Accelerated Payment Telephone Hotline: Effective February 15, 2023, the telephone hotline is no longer active.

For questions about a credit balance or account receivable (including those associated with the recovery of accelerated or advanced payments), please call the Provider Contact Center at 1.877.299.4500, option 4.

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Billing Guidance

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COVID-19 Vaccine and Monoclonal Antibody Infusion

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Frequently Asked Questions (FAQs)

At the end of the PHE, how will CMS’ review contractors conduct medical reviews for claims billed during the PHE based on approved waivers and flexibilities?

CMS contractors (MACs, RACs, and SMRC) review a very small percentage of Medicare Fee-for-Service claims each year. During the PHE, flexibilities were applied across claim types. For certain DME items, this included the non-enforcement of clinical indications for coverage. Since clinical indications for coverage were not enforced for certain DME items provided during the PHE, once the PHE ends CMS plans to primarily focus reviews on claims with dates of service outside of the PHE, for which clinical indications of coverage are applicable. We note that we may still review these DME items, as well as other items or services rendered during the PHE, if needed to address aberrant billing behaviors or potential fraud. The HHS-Office of the Inspector General may perform reviews as well. All claims will be reviewed using the applicable rules in place at the time for the claim dates of service.

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Provider Enrollment

Provider Enrollment Telephone Hotline: Effective March 20, 2023, the telephone hotline is no longer active.

Per CMS instructions, CGS must return to pre-pandemic provider enrollment operations. For additional information, please refer to our Provider Enrollment page or call the Provider Contact Center at 1.877.299.4500, option 3.

Enrollment of Ambulatory Surgical Centers (ASCs) as Hospitals

To convert back to an ASC after the PHE ends:

  • On or before May 11, 2023, email or mail a notification of intent to convert back to an ASC letter to the applicable CMS Survey and Operations Group (SOG) location.
  • Upon receipt, the CMS SOG location will terminate the temporary hospital CMS Certification Number (CCN) and send CGS a tie-out notice.
  • CGS will deactivate the temporary hospital billing privileges and reinstate the original ASC billing privileges.
  • Once the temporary hospital enrollment is terminated, the ASC must immediately comply with all applicable ASC federal participation requirements, including the Conditions for Coverage.

To participate as a hospital after the PHE ends:

  • Submit form CMS-855A to begin the regular enrollment and initial certification processes as a hospital.
  • The State Agency or Accreditation Organization will conduct an initial survey to determine compliance with all applicable hospital Conditions of Participation.

2019-Novel Coronavirus (COVID-19) Medicare Provider Enrollment Relief Frequently Asked Questions (FAQs)External PDF

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