Medicare FFS Response to the PHE on COVID-19
This revised SE Article comprises Subregulatory Guidance related to the HHS declared public health emergency (PHE) on January 31, 2020, and HHS’ authorization of waivers and modifications under Section 1135 of the Social Security Act at https://www.ssa.gov/OP_Home/ssact/title11/1135.htm, retroactive to March 1, 2020. Its content is based on publically available content at cms.gov within the Coronavirus Waivers and Flexibilities webpage at https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers, COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers at https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf, COVID-19 FAQs on Medicare Fee-for-Service Billing at https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf and Current Emergencies webpage at https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page. Under HHS’ authorization, CMS issued blanket waivers consistent with those issued for past PHE declarations. These blanket waivers prevent gaps in access to care for beneficiaries affected by the emergency. This SE article educates physicians, providers and suppliers (who bill Medicare Fee-For-Service (FFS)) on these waivers/ flexibilities and on properly billing Medicare for various health care services provided under the PHE. CMS policy or operation subject matter experts also reviewed/cleared this SE Article. This SE Article was originally issued on March 16, 2020 and has been updated multiple times to include information on waivers/ flexibilities under the PHE and proper billing.
The most current revision to this SE Article includes the following update: COVID PHE ended on May 12, 2023.
The previous version of this SE Article is available to the public and currently posted on the CMS website at https://www.cms.gov/files/document/se20011.pdf.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 12, 2023
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.