The PHE for COVID-19 Ended May 11, 2023
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. Since the CR modifier should only be reported during a PHE when a formal waiver is in place, discontinue using it and the COVID-19 narrative for claims with initial dates of service on or after May 12, 2023.
For continued claims payment of DMEPOS items provided during the PHE and to identify claims for supplies and accessories associated with DMEPOS items initially dispensed, rendered or otherwise impacted by the PHE, the DME MACs are instructing suppliers to continue the use of the CR modifier (Catastrophe/disaster related) and COVID-19 narrative. Please review the Joint DME MAC Publication Claim Submission Instruction Post-PHE – Continued Use of Modifier CR and COVID Narrative for complete information.
Post-PHE Education:
Email Address for Post-PHE Billing Questions
Do you have questions about how to bill claims now that the COVID-19 Public Health Emergency (PHE) has ended? Send your billing questions to DME-Post-PHE-questions@cgsadmin.com, and a provider educator will respond within 2 business days.
DME MAC Guidance for Dates of Service March 1, 2020, through May 11, 2023
Guidance for DMEPOS suppliers regarding requirements for face-to-face/in-person encounters, non-enforcement of clinical indications for coverage found in specific NCDs, LCDs and Policy Articles, claim instructions, CMN and DIF instructions, and ICD-10 coding has been published. Please review the entire publication: CMS Issues Interim Final Rules with Comment (CMS-1744-IFC & CMS-5531-IFC) – COVID-19 Public Health Emergency Joint DME MAC Article.
Resources:
- Beneficiary Notice Delivery Guidance in Light of COVID-19
- Billing of Part B Drugs and Enteral Nutrition to DME MACs During COVID-19 Pandemic – Dispensing Amounts
- COVID-19 Accelerated and Advance Payments
- CMS Issues Interim Final Rules with Comment (CMS-1744-IFC & CMS-5531-IFC) – COVID-19 Public Health Emergency
- CMS Telehealth Guidance
- CR Modifier for COVID-19 PHE
- Extension of Payment for Section 3712 of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) MLN Matters MM11784
- Durable Medical Equipment, Prosthetics, Orthotics and Supplies: CMS Flexibilities to Fight COVID-19
- Good Cause Rights When Filing Appeals During the PHE
- Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency
- Medicare FFS Response to the PHE on COVID-19 MLN Matters SE20011
- Signature Requirements on Proof of Delivery During the COVID-19 Pandemic
- Summary of COVID-19 Emergency Declaration Waivers & Flexibilities for Health Care Providers
Updated: 03.05.24