Administration and COVID19
This page contains resources about Administration including Billing and Reimbursement as well as HR resources.
New: State Medicaid COVID-19 Resource Guide – Posted 7/21/2020
NCCHCA released its most recently updated Medicare-COVID-Billing Grid, last updated on May 6, 2020. Members should use this document and disregard any other Medicare guidance sent in previous NCCHCA communications.
NC Medicaid Telehealth Billing Code Summary NC Medicaid released this updated table of guidance for billing telehealth and virtual care codes. This guide includes recently revised guidance on which Place of Service (POS) code to use for real-time video conferencing services.
COVID-19: New and Expanded Flexibilities for RHCs & FQHCs during the Public Health Emergency
On July 6, CMS updated MLN Matters Article SE20016 to clarify how Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can apply the Cost Sharing (CS) modifier to preventive services furnished via telehealth. This update includes additional claim examples and a new section on the RHC Productivity Standard. New Billing Matrix can be found here.
COVID-19 Revenue Loss Calculator/Emergency Funding Budget Estimate
- COVID 19 Revenue Loss Calculator and Emergency Funding Budget Estimate_3.25.20
Thank you to Piedmont Health Services and Cabarrus Rowan Community Health Centers for their assistance in developing the attached COVID-19 Revenue Loss Calculator & Emergency Funding Budget Estimate. Please use the tool to tell the financial story of your health center during the COVID-19 public health crisis, documenting your loss in revenue due and added costs due to the virus. The tool will provide valuable information to funders, health center boards and leadership staff, public officials, NCCHCA, and a variety of community and national stakeholders.
NCDHHS/NC Medicaid Special Bulletins:
- SPECIAL BULLETIN COVID-19 #34: Telehealth Clinical Policy Modifications – Definitions, Eligible Providers, Services and Codes
- SPECIAL BULLETIN COVID-19 #36: Telehealth Clinical Policy Modifications – Outpatient Specialized Therapies & Dental Services
These Special Bulletins also clarify the billing guidance for “place of service,” addressing claims issues some providers recently experienced.
- NACHC Elevate Reimbursement Tips
- CMS Advanced Payment Tip Sheet
- North Carolina Payers Telehealth Policies in Response to COVID-19
General/ New Items
NCCHCA compiled some ideas on how to use staff time during periods of low productivity. Options for Using Staff during Covid
Information On the Families First Coronavirus Response Act (FFCRA)
Important: Who is a “health care provider” who may be excluded by their employer from paid sick leave and/or expanded family and medical leave?
For the purposes of employees who may be exempted from paid sick leave or expanded family and medical leave by their employer under the FFCRA, a health care provider is anyone employed at any doctor’s office, hospital, health care center, clinic, post-secondary educational institution offering health care instruction, medical school, local health department or agency, nursing facility, retirement facility, nursing home, home health care provider, any facility that performs laboratory or medical testing, pharmacy, or any similar institution, employer, or entity. This includes any permanent or temporary institution, facility, location, or site where medical services are provided that are similar to such institutions.
This definition includes any individual employed by an entity that contracts with any of the above institutions, employers, or entities institutions to provide services or to maintain the operation of the facility. This also includes anyone employed by any entity that provides medical services, produces medical products, or is otherwise involved in the making of COVID-19 related medical equipment, tests, drugs, vaccines, diagnostic vehicles, or treatments. This also includes any individual that the highest official of a state or territory, including the District of Columbia, determines is a health care provider necessary for that state’s or territory’s or the District of Columbia’s response to COVID-19.
To minimize the spread of the virus associated with COVID-19, the Department encourages employers to be judicious when using this definition to exempt health care providers from the provisions of the FFCRA.