CMS Provides Additional Billing Guidance for COVID Services

June 3, 2020

Monday, the Centers for Medicare and Medicaid Services (CMS) released an updated MLN Matters article, clarifying use of the “CR” modifier and “DR” condition code for billing services to COVID-19 patients.  The CR modifier is used at the claim expense line level and the DR condition code at the claim level. Both are used to ensure proper payment and track services provided under the various COVID-19 waivers. The article includes a grid, providing instructions on the condition code or modifier to be used and information on the specific waiver invoked.

WSHA is continuing to provide Medicare updates to the Washington Healthcare Forum COVID-19 Work Group.  The Work Group has been compiling questions from providers and posting answers from commercial plans and Medicaid, including Medicaid managed care.  They are posted in a Frequently Asked Questions format on the OneHealthPort website.  The website includes telemedicine policies and billing requirements, COVID-19 testing codes and requirements and links to the COVID-19 webpage for most major carriers.  If you have a COVID-19 billing or payment question for which you have not yet found an answer, please send it to Andrew Busz, WSHA Policy Director, Finance at


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