- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
- Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) - Request for Information
- Dr. Mehmet Oz Shares Vision for CMS
- CMS Refocuses on its Core Mission and Preserving the State-Federal Medicaid Partnership
- Social Factors Help Explain Worse Cardiovascular Health among Adults in Rural Vs. Urban Communities
- Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation: Request for Input
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- 2025 Marketplace Integrity and Affordability Proposed Rule
- Rural America Faces Growing Shortage of Eye Surgeons
- NRHA Continues Partnership to Advance Rural Oral Health
- Comments Requested on Mobile Crisis Team Services: An Implementation Toolkit Draft
- Q&A: What Are the Challenges and Opportunities of Small-Town Philanthropy?
Depressed, Rural Moms Face Greater Health Challenges—and so Do Their Kids
This article summarizes research that found rural, low-income mothers with chronic depression were likely to experience more health problems and face challenges in dealing with their children’s behavioral problems. It discusses how physician distrust and stigma keep rural mothers from seeking mental health treatment. Read more here.
CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on the Home Health Care Consumer Assessment of Healthcare Providers and Systems Survey, which is used to collection information on the quality of care provided by Medicare-certified home health agencies. Comments are due by May 5, 2020. Read more here.
Working to Advance the Health of Rural Americans: An Update from the ABFM
This article covers existing disparities between the health of rural and urban Americans and describes research from the American Board of Family Medicine (ABFM) on the role of Family Physicians (FPs) in improving rural healthcare delivery. It includes proposed solutions from the ABFM to maintain the presence of FPs in rural areas. Read it here.
FCC: Rural Digital Opportunity Fund, Connect America Fund
Final rule from the Federal Communications Commission adopting the framework for the Rural Digital Opportunity Fund, which will allocate funds to establish broadband networks in rural unserved locations. Read more here.
Social Determinants of Health in Rural Communities Toolkit
Rural Health Information Hub’s latest toolkit assembles resources and model programs that support rural organizations in implementing programs to address social determinants of health in their communities. Learn how to define, understand, and address social determinants of health and overcome barriers specific to rural areas. Created in collaboration with the NORC Walsh Center for Rural Health Analysis. Read more here.
Visualizing COVID-19 in Appalachia
The COVID-10 Cases in Appalachia map displays the current number of confirmed cases of COVID-19 in Appalachia and throughout the United States. Higher numbers of cases are marked by larger dots, while smaller numbers of confirmed cases are represented by smaller dots. By clicking on a location, users can see confirmed COVID-19 cases and any related deaths at the county level. This map is automatically updated throughout the day drawing on data collected by the Johns Hopkins University. Due to frequent changes, it is advised that users refresh their browsers often when viewing the map. As of April 2, 11:15 am (ET), there were 5,433 confirmed COVID-19 cases in 314 Appalachian counties, up from 1,686 confirmed cases in 208 Appalachian counties on March 26.
Explore County-level Coronavirus Impact Planning is a searchable data base offering demographic data snapshots of confirmed COVID-19 cases and deaths in relation to hospital bed counts, population and businesses, and categories of people at risk for COVID-19 in each one of the nation’s counties. By hovering over each statistical icon, users can learn more about the supporting data. COVID-19 related data is updated daily
New ICD-10-CM Diagnosis Code, U07.1, for COVID-19
In response to the national emergency that was declared concerning the COVID-19 outbreak, a new diagnosis code, U07.1, COVID-19, has been implemented, effective April 1, 2020.
As a result, an updated ICD-10 MS-DRG GROUPER software package to accommodate the new ICD-10-CM diagnosis code, U07.1, COVID-19, effective with discharges on and after April 1, 2020, is available on the CMS MS-DRG Classifications and Software webpage.
This updated GROUPER software package (V37.1 R1) replaces the GROUPER software package V37.1 that was developed in response to the new ICD-10-CM diagnosis code U07.0, Vaping-related disorder, also effective with discharges on and after April 1, 2020, that is currently available on the MS-DRG Classifications and Software webpage.
Providers should use this new code, U07.1, where appropriate, for discharges on or after April 1, 2020. Refer to the updated MLN Matters Articles for additional Medicare Fee-For-Service information:
- Update to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for Vaping Related Disorder and 2019 Novel Coronavirus (COVID-19)
- Update to the Home Health Grouper for New Diagnosis Codes for Vaping Related Disorder and COVID-19
- April 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.1 R1
For detailed information regarding the assignment of new diagnosis code U07.1, COVID-19, under the ICD-10 MS-DRGs, visit the MS-DRG Classifications and Software webpage. The announcement is located under the “Latest News” heading.
For additional information related to the new COVID-19 diagnosis code, visit the CDC website.
Billing for Multi-Function Ventilators (HCPCS Code E0467) under the COVID-19 Public Health Emergency and Otherwise
CMS recognizes that in these important times, in particular, beneficiaries, health care clinicians, suppliers, and manufacturers are looking for the broadest possible access to ventilators for their care needs. We are taking a number of steps to increase access to and remind suppliers about certain options available to them and beneficiaries regarding multi-function ventilators.
Effective immediately, CMS is suspending claims editing for multi-function ventilators when there are claims for separate devices in history that have not met their reasonable useful lifetime.
For more information on multi-function ventilators, see MLN Matters Special Edition Article SE20012.
Billing for Professional Telehealth Distant Site Services During the Public Health Emergency — Revised
This corrects a prior message that appeared in our March 31, 2020 Special Edition.
Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. When billing professional claims for all telehealth services with dates of services on or after March 1, 2020, and for the duration of the Public Health Emergency (PHE), bill with:
- Place of Service (POS) equal to what it would have been had the service been furnished in-person
- Modifier 95, indicating that the service rendered was actually performed via telehealth
As a reminder, CMS is not requiring the CR modifier on telehealth services. However, consistent with current rules for telehealth services, there are two scenarios where modifiers are required on Medicare telehealth professional claims:
- Furnished as part of a federal telemedicine demonstration project in Alaska and Hawaii using asynchronous (store and forward) technology, use GQ modifier
- Furnished for diagnosis and treatment of an acute stroke, use G0 modifier
There are no billing changes for institutional claims; critical access hospital method II claims should continue to bill with modifier GT.
CMS Summary of Actions Taken
Here is a summary of recent Centers for Medicare & Medicaid Services (CMS) actions taken in response to the COVID-19 virus, as part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, click here www.coronavirus.gov. For information specific to CMS, please visit the CMS News Room and Current Emergencies Website. CMS updates these resources on an ongoing basis throughout the day; the information below is current as of April 3, 2020 at 10:00 AM.
Trump Administration Issues Key Recommendations to Nursing Homes, State and Local Governments
Recently, CMS, in consultation with the Centers for Disease Control and Prevention (CDC), issued critical recommendations to state and local governments, as well as nursing homes, to help mitigate the spread of the 2019 Novel Coronavirus (COVID-19) in nursing homes. The recommendations build on and strengthen recent guidance from CMS and CDC related to effective implementation of longstanding infection control procedures.
CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic
CMS approved its 44th state Medicaid waiver delivering urgent regulatory relief to ensure States can quickly and effectively care for their most vulnerable citizens. In light of the urgent and evolving needs of states during the COVID-19 crisis, CMS developed a toolkit to facilitate expedited application and approval of State waivers requests in record time. The waivers support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported. Recently approved states include Alaska, Arkansas, and Nebraska.
CMS also approved one more state waiver amendment requests for California to give emergency flexibilities in their programs that care for the elderly and people with disabilities, bringing the total to 17 approvals across 15 states.
1915(c) Appendix K Waivers
Medicare and Telehealth Services Blog
The Social Security Administration (SSA) featured a guest blog by CMS Administrator, Seema Verma with important information on Medicare coverage and recently expanded coverage of telehealth services. CMS actions protect beneficiaries while maintaining trusted access to care in the face of the coronavirus pandemic.
Medicaid Telehealth Flexibilities for Rural Health Care Substance Use Disorder
CMS released an Informational Bulletin to states that explains how states can use telehealth delivery methods to expand access to Medicaid services, including substance use disorder (SUD) treatment and services. The guidance outlines how telehealth may be used to service rural communities, high-risk individuals, school-based health centers and SUD programs. It provides information about Medicaid coverage and reimbursement of SUD treatment services and supports CMS actions in response to the COVID-19 virus as well as the opioid epidemic.
Updates Available to Medicaid and CHIP Frequently Asked Questions
CMS issued additional Frequently Asked Questions for State Medicaid and Children’s Health Insurance Program (CHIP) agencies to aid states in their response to the COVID-19 outbreak. Topics include: emergency preparedness and response; flexibilities around eligibility and enrollment; benefits, premiums and cost sharing; financing; managed care; fair hearings; health information exchanges; and COVID-19 T-MSIS coding guidance.