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CSA 052220g
May 22, 2020
DME MACs and CMS COVID-19 Updates
Dear Valued Customer,
Change Healthcare is committed to keeping you informed regarding the ongoing publications related to COVID-19. The details are rapidly changing, and these CSAs are one way we’re sharing the details that pertain specifically to our pharmacy customers.

This notification is to inform you of the following items recently published by CMS, HHS, and the DME MACs as they relate to pharmacies.
Also included is an outline of previously published notifications to help consolidate all COVID-19 items into one reference guide.
(The below details contain content directly from publications provided from the above sources)
New / Updated Items of Interest:
  • HHS Advisory Opinion Further Supports Pharmacist-Provided COVID-19 Testing: Federal Action Preempts State, Local Policies 
    • HHS issued a clarifying opinion this week, May 19, 2020, regarding the executive intent of prior guidance on pharmacist-provided COVID-19 testing and how that relates to interpretations of possible state and local conflicts.  
    • Click here for additional details.
  • COVID-19: Payment for Diagnostic Laboratory Tests 
    • Earlier this year, CMS took action to ensure America’s patients, healthcare facilities, and clinical laboratories were prepared to respond to COVID-19. To help increase testing and track new cases, CMS and AMA developed new HCPCS codes that laboratories can use to bill for certain COVID-19 diagnostic tests. There is no cost-sharing for Medicare patients.
    • Click here for additional details.
  • COVID-19: Which Laboratory Claims Require the NPI of the Ordering/Referring Professional?
    • During the COVID-19 crisis, CMS is relaxing billing requirements for a limited number of laboratory tests required for a COVID-19 diagnosis. Any healthcare professional authorized under state law may order these tests. Medicare will pay for these tests without a written order from the treating physician or other practitioner:
      • If an order is not written, you do not need to provide the National Provider Identifier (NPI) of the ordering or referring professional on the claim.
      • If an order is written, include the NPI of the ordering or referring professional, consistent with current billing guidelines.
    • Click here for additional details.
Previously published CSAs related to COVID-19
Change Healthcare continues to monitor this rapidly evolving situation and will provide updates as circumstances change.

Change Healthcare is proud to be your business partner and remains committed to your success. 
Thanks for your attention to this announcement,

Change Healthcare
Disclaimer: This notice contains CONFIDENTIAL information intended only for the use of Change Healthcare customers. If you are NOT the intended recipient of this notice or an agent or employee responsible for delivering it to the intended recipient, you are hereby notified that any unauthorized dissemination or copying of the notice or the information contained therein is strictly prohibited.
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