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June 17, 2020 - Updated: 06.22.20

COVID-19 Diagnostic Laboratory Tests: Billing for Clinician Services

Physicians and non-physician practitioners (NPPs): Here are several reminders related to billing for COVID-19 symptom and exposure and specimen collection performed on and after March 1, 2020:

  • Use CPT code 99211 to bill for assessment and collection provided by clinical staff (such as pharmacists) incident to your services, unless you are reporting another Evaluation and Management (E/M) code for concurrent services. This applies to all patients, not just established patients.
  • Submit the CS modifier with 99211 (or other E/M code for assessment and collection) to waive cost sharing.
  • Contact your Medicare Administrative Contractor (MAC) if you did not include the CS modifier when you submitted 99211 so they can reopen and reprocess the claim.
  • We will automatically reprocess claims billed for 99211 that were denied due to place of service editing.

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