The Latest CMS COVID-19 Billing Updates for Hospitals
Thursday, June 4th, 2020

CMS’ latest and revised COVID-19 billing policy seeks to help hospitals and alternative care sites get paid for treatment given during the emergency. Late last month, CMS revised FAQs regarding Medicare fee-for-service billing. The revised FAQs provided more clarity on how CMS enforced an increase in hospital IPPS reimbursement, including the process involved in identifying COVID-19 discharges.

Most of the new questions focused on payments based on the Coronavirus Help, Relief and Economic Protection Act (CARES) for the Hospital Inpatient Prospective Payment Program (IPPS). The CARES Act, passed at the end of March, provides billions of dollars in funding to hospitals and other healthcare facilities, including a provisional 20% rise in IPPS patient reimbursements for hospitalizations related to the pandemic.

According to the FAQs, the amounts hospitals will receive for COVID-19 hospitalizations will vary based on the date of discharge. CMS issued the new payment rates for COVID-19 discharges on and after the 27th of January and on or before the 31st of March, as well as on or after the first of April, over the length of the emergency period.

Along with COVID-19 billing updates for the IPPS, CMS also provided guidelines on how hospitals should bill for services provided at alternative care sites developed to expand capacity during the emergency.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.