Medicare to Pay for Counseling Patients to Self-Isolate During COVID-19 Testing
By David Doolittle


If you test patients for COVID-19, you likely tell them that self-isolating before they receive results is beneficial in stopping spread of the disease. 

But did you know such counseling can benefit your practice as well? 

The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention recently announced that Medicare will pay you for counseling your patients – at the time of testing – about the importance of self-isolation while they await their test results.  

“CMS will use existing evaluation and management (E/M) payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered,” the agencies said.   

According to CPT guidelines, physicians must document the total time of the visit, that more than 50% was spent on counseling and/or coordination, and the details of the counseling – for either in-person or telemedicine visits. For example, if a visit is 40 minutes long, a minimum of 21 minutes would have to be spent on counseling. 

The Texas Medical Association recommends that documentation should support the services provided and relevant findings, and that physicians should avoid excessive documentation to justify a higher level of service. 

“Provider counseling to patients, at the time of their COVID-19 testing, will include the discussion of immediate need for isolation, even before results are available, the importance to inform their immediate household that they too should be tested for COVID-19, and the review of signs and symptoms and services available to them to aid in isolating at home,” CMS and CDC said in a joint press release. 

Separating people who have been tested for COVID-19 can reduce transmission of the virus that causes the disease by up to 86%, “compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise,” CMS and CDC said. 

To help you document counseling for each patient, CMS has created a Counseling Check List that also provides information and resources on self-isolation. 

TMA also recommends keeping the checklist in each patient’s medical record, if possible.

More information, tips and resources can be found on the TMA COVID-19 Resource Center, which includes a section on specimen collection and testing.


Last Updated On

August 06, 2020

Originally Published On

August 06, 2020

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David Doolittle


(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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