COVID-19
Ending the COVID-19 PHE Resources
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, 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 continues to update 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.
- CMS Current Emergencies webpage
- Provider-specific fact sheets
about COVID-19 PHE waivers and flexibilities
- COVID-19 PHE Transition Roadmap
The Centers for Medicare & Medicaid Services (CMS) is committed to protecting American patients and residents by ensuring health care facilities have up-to-date information to adequately respond to Coronavirus (COVID-19) concerns. Refer to the CMS Current Emergencies web page to access waiver and flexibility information
as well as various updates and guidance during this public health emergency.
Refer to the CMS Podcast and Transcripts web page to access Coronavirus COVID-19 Stakeholder Calls. To receive information about these calls, and to receive email updates directly from CMS, go to the CMS website
, scroll to the bottom of the page and to the "Receive Email Updates" icon and enter your email address and submit (select Open Door Forums).
CGS has provided CMS COVID-19 related resources (not all inclusive) below. Please share with your appropriate staff. Click on the resource below to view.
- Section 11235 and Section 1812(f) Waivers
- Accelerated/Advance Payment
- All Providers
- Cost Report (All Provider Types)
- COVID-19 Toolkits
- COVID-19 Public Health Emergency (PHE) Tip Sheets
- COVID-19 Vaccine and Monoclonal Antibody Infusion
- End Stage Renal Disease (ESRD) Facilities
- Frequently Asked Questions (FAQs)
- Home Health Providers
- Hospice Providers
- Hospital
- Laboratories
- Medicare Payment for COVID-19 Vaccination Administration in the Home
- Opioid Treatment Program (OTP) Providers
- Provider Enrollment
- Skilled Nursing Facility (SNF)
- Telehealth
- MLN Connects Special Editions
- MLN Matters® Articles
- Press Releases
- Sequestration
Section 1135 and Section 1812(f) Waivers
The Secretary of the Department of Health & Human Services declared a public health emergency (PHE) in the entire United States on January 31, 2020. On March 13, 2020 Secretary Azar authorized waivers and modifications under Section 1135 of the Social Security Act (the Act), retroactive to March 1, 2020. Refer to the MLN Matters Special Edition article, SE20011 – Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) for additional information.
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 Program" 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-19" 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 1.866.276.9558, option 5.
All Providers
- CARES Act Provider Relief Fund
- Centers for Disease Control and Prevention (CDC) COVID-19
- Coronavirus (COVID-19) Stakeholder Calls Recordings/Transcripts
- Coronavirus Waivers & Flexibilities (Includes provider-specific facts sheets on waivers and flexibilities)
- Coverage and Payment Related to COVID-19 Medicare Fact Sheet
- COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers
- Emergency Medical Treatment and Labor Act (EMTALA) Requirements and Implications Related to Coronavirus Disease 2019 (COVID-19)
- Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes (Revised)
- Guidance for Use of Certain Industrial Respirators by Health Care Personnel
- ICD-10 CM Official Coding and Reporting Guidelines April 1, 2020 through September 30, 2020
- ICD-10-CM Official Coding Guidelines – Supplement Coding encounters related to COVID-19 Coronavirus Outbreak Effective: February 20, 2020
- Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness (2019-nCOV)
- Request for Accelerated/Advance Payment
- Workplace, School and Home Guidance
Cost Report (All Provider Types)
CMS will delay the cost report filing deadlines with a fiscal year ending on or between March 1, 2020 through December 31, 2020. This applies to all provider types including hospitals, SNFs, HHAs, hospices, ESRDs, RHCs, FQHCs, CMHCs, OPOs, histocompatibility labs, and home office cost statements.
Cost Reporting Period Ending | Initial Due Date | Extended Due Date |
---|---|---|
06/30/2020 | 11/30/2020 | 02/01/2021 |
07/31/2020 | 12/31/2020 | 03/01/2021 |
08/31/2020 | 01/31/2021 | 03/31/2021 |
09/30/2020 | 03/01/2021 | 04/30/2021 |
10/31/2020 | 03/31/2021 | 06/01/2021 |
11/30/2020 | 04/30/2021 | 06/30/2021 |
12/31/2020 | 05/31/2021 | 08/02/2021 |
COVID-19 Public Health Emergency (PHE) Tip Sheets
- The Home Health Quality Reporting Program (HH QRP)
- The Inpatient Rehabilitation Facility Quality Reporting Program (IRF QRP)
- The Long-Term Care Hospital Quality Reporting Program (LTCH QRP)
- The Skilled Nursing Facility Quality Reporting Program (SNF QRP)
COVID-19 Vaccine and Monoclonal Antibody Infusion
- Coding for COVID-19 Vaccine Shots
- COVID-19 Vaccine and Monoclonal Antibody Infusion – Part A / HH&H Billing Guidance
- Medicare Billing for COVID-19 Vaccine Shot Administration
- Monoclonal Antibody COVID-19 Infusion
End Stage Renal Disease (ESRD) Facilities
Frequently Asked Questions (FAQs)
- 2019-Novel Coronavirus (COVID-19) Medicare Provider Enrollment Relief Frequently Asked Questions (FAQs)
- Accelerated and Advance Payment Repayment & Recovery Frequently Asked Questions
- COVID-19 Frequently Asked Questions (FAQs)
(Includes questions related to various topics)
- COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing
- COVID-19 Provider Burden Relief Frequently Asked Questions
- Emergency Medical Treatment and Labor Act (EMTALA) Requirements and Implications Related to Coronavirus Disease 2019 (COVID-19)
- Frequently Asked Questions (FAQs), CLIA Guidance During the COVID-19 Emergency
- Frequently Asked Questions for State Survey Agency and Accrediting Organization Coronavirus Disease 2019 (COVID-19) Survey Suspension
- Nursing Home Five Star Quality Rating System updates, Nursing Home Staff Counts, and Frequently Asked Questions
- Open Payment Frequently Asked Question (FAQs)
- Provider Survey and Certification Frequently Asked Questions
Home Health Providers
- Extension of Auto-Cancellation Date of Requests for Anticipated Payments (RAPs)
- Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) in Home Health Agencies (HHAs)
- Reason Code 7CS17: Billing COVID-19 Vaccine Administration for Beneficiaries with Medicare Advantage Plans
Hospice Providers
- Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) by Hospice Agencies
- Reason Code 7CS17: Billing COVID-19 Vaccine Administration for Beneficiaries with Medicare Advantage Plans
Hospital
Laboratories
- Education Article: COVID Serology Testing
- July 30, 2020, MLN Connects – COVID-19: Laboratory Claims Requiring the NPI of the Ordering/Referring Professional – Update
- Notification to Surveyors of the Authorization for Emergency Use of the CDC 2019-Novel Coronavirus (2019-nCOV) Real-Time RT-PCR Diagnostic Panel Assay and Guidance for Authorized Laboratories
- COVID-19 Diagnostic Laboratory Tests: Billing for Clinician Services
Opioid Treatment Program (OPT) Providers
CMS revised regulation text to allow audio-only telephone calls for the therapy and counseling portions of the weekly bundles and the add-on code for additional counseling or therapy (HCPCS code G2080) for beneficiaries with opioid use disorders, provided all other requirements are met. Providers may conduct the periodic patient assessments (HCPCS code G2077) via two-way interactive audio-video communication technology or by telephone only in cases where the beneficiary does not have access to two-way interactive technology. For more details, refer to the Opioid Billing & Payment information on the CMS website.
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 1.866.276.9558, 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.
Skilled Nursing Facility (SNF)
- Additional Emergency and Disaster-Related Policies and Procedures That May be Implemented Only with a § 1135 Waiver
- COVID-19 ICD-10 Code U07.1 and SNF PDPM Assessment Diagnosis
Telehealth
Refer to the List of Telehealth Services for the Covered Telehealth Services for PHE and the COVID-19 pandemic, effective March 1, 2020
. An updated Telehealth Services MLN Booklet
is available on the CMS website. Also available is the General Provider Telehealth and Telemedicine Tool Kit
.
Video now available on Medicare Coverage and Payment of Virtual Services, providing answers to common questions about the Medicare telehealth services benefit.
- 03.30.2020 – Telehealth Services During the Public Health Emergency
- 03.17.2020 – President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak
- 03.17.2020 Fact Sheet – Medicare Telemedicine Health Care Provider Fact Sheet
- 03.17.2020 – Medicare Telehealth Frequently Asked Questions (FAQs)
- 03.09.2020 Press Release – Telehealth Benefits in Medicare are a Lifeline for Patients During Coronavirus Outbreak
MLN Connects Special Editions
Subscribe to the weekly email newsletter for health care professionals.
- 05.11.2021 – Special Edition – CMS Expanding Efforts to Grow COVID-19 Vaccine Confidence and Uptake Amongst Nation's Most Vulnerable
- 04.27.2021 – Special Edition – Proposed Rule for Inpatient & Long-Term Care Hospitals
- 04.20.2021 – Special Edition – COVID-19 Update: FDA Revoked the EUA for Bamlanivimab When Administered Alone
- 04.14.2021 – Special Edition – J&J COVID-19 Vaccine: Health Alert
- 03.30.2021 – Special Edition – Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension
- 03.15.2021 – Special Edition – Medicare Payment Increase for COVID-19 Vaccine
- 03.10.2021 – Special Edition – CMS Updates Nursing Home Guidance with Revised Visitation Recommendations
- 12.22.2020 – Special Edition – COVID-19 Vaccine Codes: Updated Effective Date for Moderna
- 12.18.2020 – Special Edition – COVID-19: Add-on Payment for New Treatments
- 12.14.2020 – Special Edition – COVID-19 Vaccine Codes: Updated Effective Date for Pfizer-BioNTech
- 12.09.2020 – Special Edition – COVID-19: Medicare Coverage of Antibody Treatment
- 12.03.2020 – Special Edition – COVID-19 Antibody Treatment and Enforcement Discretion Reminder
- 11.12.2020 – Special Edition – COVID-19 Vaccine Codes and PC-ACE Software Update
- 11.10.2020 – Special Edition – CMS Takes Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment
- 10.28.2020 – Special Edition – Coverage of Life-Saving COVID-19 Vaccines & Therapeutics
- 10.08.2020 – CMS Announces New Repayment Terms for Medicare Loans Made to Providers During COVID-19
- 08.04.2020 – PFS, OPPS, and IRF: FY 2021 Payment Rules
- 07.31.2020 – FY 2021 Medicare Payment Policies for IPFs, SNFs, and Hospices
- 07.30.2020 – Payment for COVID-10 Counseling, Reporting Hospital Therapeutics, Out-of-Pocket Drug Costs
- 07.23.2020 – COVID-19: New Resources to Protect Nursing Home Residents
- 07.17.2020 – COVID-19: Nursing Home Testing, SNF Benefit Period Waiver
- 06.11.2020 – Medicare Coverage of COVID-19 Testing for Nursing Home Residents and Patients
- 06.01.2020 – Using the CR Modifier and DR Condition Code
- 05.29.2020 – COVID-19: New FAQs on Medicare FFS Billing
- 05.19.2020 – COVID-19: Payment for Lab Tests, Safely Reopening Nursing Homes, Lab & Ambulance Claims
- 05.15.2020 – COVID-19: Nursing Home Deadline, Telephone E&M Visits, Hospital time Studies and Calls
- 05.12.2020 – COVID-19: Additional Waivers, Price Transparency, and CMS Letter to Nursing Homes
- 05.08.2020 – COVID-19: Nursing Home Reporting, Updated Telehealth Video, Pharmacies & Other Suppliers Can Enroll as Labs, IRF Flexibilities
- 04.30.2020 – COVID-19 Second Round of Sweeping Changes, RHC & FQHC Flexibilities, EMTALA
- 04.27.2020 – COVID-19: CMS Reevaluates Accelerated Payment Program and Suspends Advance Payment Program
- 04.20.2020 – COVID-19: Nursing Home Transparency, Recommendations for Areas with Low Incidence of Disease
- 04.17.2020 – COVID-19: RHC & FQHC Flexibilities, Increased Payment for Lab Tests, Hospital Waivers, Call Audio and Transcript
- 04.15.2020 – COVID-19: Reprocessing Hospital Claims, Essential Diagnostic Services, Non-Invasive Ventilators
- 04.10.2020 – COVID-19: Infection Control, Maximizing Workforce, Updated Q&A, CS Modifier for Cost-Sharing, Payment Adjustment Suspended
- 04.07.2020 – COVID-19: Telehealth Video, Coinsurance and Deductible Waived, ASC Attestations, Ambulance Modifiers, Lessons from Front Lines, MLN Call Today
- 04.03.2020 – Telehealth Billing Correction, Nursing Home Recommendations, Billing for Multi-Function Ventilators, New ICD-10-CM Diagnosis Code
- 03.31.2020 – COVID-19: Regulatory Changes, Telehealth Billing, and Specimen Collection Codes
- 03.30.2020 – COVID-19: Financial Relief, Nursing Home Telehealth, Quality Reporting, Clinical Laboratories, Hospital Data Sharing
- 03.26.2020 – COVID-19: Enrollment Relief, Open Payments, Beneficiary Notices
- 03.23.2020 – COVID-19: Relief for Quality Reporting Programs and Provider Enrollment
- 03.20.2020 – COVID-19: Telehealth and Non-Essential Procedures
- 03.17.2020 – President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak
- 03.16.2020 – COVID-19: FFS Response and Nursing Home Visitor Guidance
- 03.13.2020 – COVID-19: Test Pricing, Diagnostic Lab Tests, Pricing & Codes, and EHB Coverage
- 03.09.2020 – COVID-19 Response: CMS Issues FAQs to Assist Medicare Providers
- 03.06.2020 – CMS Develops Additional Code for Coronavirus Lab Tests
- 03.04.2020 – CMS Announces Actions to Address Spread of Coronavirus
MLN Matters® Articles
- SE20016 – New and Expanded Flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) During the COFID-19 Public Health Emergency (PHE)
- SE20015 – New Waivers for Inpatient Prospective Payment System (IPPS) Hospitals, Long-Term Care Hospitals (LTCHs), and Inpatient Rehabilitation Facilities (IRFs) due to Provisions of the CARES Act
- SE20011 – Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)
Press Releases
Review all CMS Coronavirus disease 2019 (COVID-19) press releases.
Sequestration
The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31, which was then extended to March 31, 2021. An Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes, signed into law on April 14, 2021, extends the suspension period to December 31, 2021. CGS will release any previously held claims with dates of service on or after April 1, and reprocess any claims paid with the reduction applied. No provider action is required. Refer to the CMS Special Edition MLN Connects dated April 16, 2021.