$8.3B Coronavirus Funding Bill Approved
March 2020 ~
During the first week in March, the U. S. House and Senate approved an $8.3 billion funding bill to support ongoing efforts to combat COVID-19 (Coronavirus). On March 6, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (H.R. 6074) was finalized by the president.
Within the Department of Health and Human Services (HHS), according to the bill summary, H.R. 6074) provides supplemental appropriations for:
- the Food and Drug Administration (FDA),
- the Centers for Diseases Control and Prevention (CDC),
- the National Institutes of Health (NIH), and
- the Public Health and Social Services Emergency Fund.
In addition, the bill provides supplemental appropriations for:
- the Small Business Administration,
- the Department of State, and
- the U.S. Agency for International Development.
The programs funded by the bill address issues such as
- developing, manufacturing, and procuring vaccines and other medical supplies;
- grants for state, local, and tribal public health agencies and organizations;
- loans for affected small businesses;
- evacuations and emergency preparedness activities at U.S. embassies and other State Department facilities; and
- humanitarian assistance and support for health systems in the affected countries.
The $8.3 billion spending package allocates around $7.76 billion to federal, state and local agencies dealing with the virus. For states already battling more advanced outbreaks, the funds will go to supporting public lab testing, isolation and quarantine costs, sanitization of public areas and tracking the virus. The bill includes more than $3 billion towards vaccine research and will also provide support to states through grant funding, some of which will be based on a population-based CDC formula.
Of note, there are two new HCPCS codes for healthcare providers who need to test patients for Coronavirus. Providers using the Centers for Disease Control and Prevention (CDC) 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel may bill for that test using the newly created HCPCS code (U0001). A second new HCPCS code (U0002) can be used by laboratories and healthcare facilities to bill Medicare as well as by other health insurers that choose to adopt this new code for such tests. HCPCS code (U0002) generally describes 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) using any technique, multiple types or subtypes (includes all targets). The Medicare claims processing system will be able to accept these codes on April 1, 2020, for dates of service on or after February 4, 2020.
Additionally, the bill also allows HHS to temporarily waive certain Medicare restrictions and requirements regarding telehealth services during the public health emergency. These updated restrictions and requirements, as seen in the fact sheet, can be seen below.
Original Medicare – Telehealth and Other Communication-Based Technology Services
Beneficiaries can communicate with their doctors or certain other practitioners without necessarily going to the doctor’s office in person for a full visit.
Since 2018, Medicare pays for “virtual check-ins” for patients to connect with their doctors without going to the doctor’s office. These brief, virtual check-in services are for patients with an established relationship with a physician or certain practitioners where the communication is not related to a medical visit within the previous 7 days and does not lead to a medical visit within the next 24 hours (or soonest appointment available). The patient must verbally consent to the use of virtual check-ins and the consent must be documented in the medical record prior to the patient using the service. The
Medicare coinsurance and deductible would apply to these services.
Doctors and certain practitioners may bill for these virtual check-in services furnished through several communication technology modalities, such as telephone (HCPCS code G2012) or captured video or image (HCPCS code G2010).
Medicare also pays for patients to communicate with their doctors without going to the doctor’s office using online patient portals. The individual communications, like the virtual check-ins, must be initiated by the patient; however, practitioners may educate beneficiaries on the availability of this kind of service prior to patient initiation. The communications can occur over a 7-day period. The services may be billed using CPT codes 99421-99423 and HCPCS codes G2061-G206, as applicable. The Medicare coinsurance and deductible would apply to these services.
In addition, Medicare beneficiaries living in rural areas may use communication technology to have full visits with their physicians. The law requires that these visits take place at specified sites of service, known as telehealth originating sites, and receive services using a real-time audio and video communication system at the site to communicate with a remotely located doctor or certain other types of practitioners. Medicare pays for many medical visits through this telehealth benefit. Certain beneficiaries, such as those needing a monthly end-stage renal disease visit or those needing treatment for substance use disorders or co-occurring mental health disorder may access telehealth services from their home without traveling to an originating site. The Medicare coinsurance and deductible would apply to these services.
Medicare also pays doctors for certain non-face-to-face care management services and remote patient monitoring services. The Medicare coinsurance and deductible would apply to these services.
Medicare Advantage (Part C) and Part D – Telehealth and other Communication Based Technology Services
Medicare Advantage plans may provide their enrollees with access to Medicare Part B services via telehealth in any geographic area and from a variety of places, including beneficiaries’ homes. With this flexibility, it is possible that beneficiaries in Medicare Advantage plans can receive clinically appropriate services for the treatment of COVID-19 via telehealth.
For more information on Coverage and Payment Related to COVID-19 Medicare, see the CMS Fact Sheet.
Source(s): Remarks by U.S. President at Signing of H.R. 6074; H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (pdf); Becker’s Hospital Review; HealthcareDIVE; Politico; Kaiser Health News; The Hill; National Law Review;