Coverage Assistance Fund Reimburses for Vaccine-Incurred Costs to Practices. The Coverage Assistance Fund (CAF), a new program of the Health Resources & Services Administration (HRSA), is now available to reimburse practices for rejected claims to providers who are administering the COVID-19 vaccine to patients whose health insurance plans lack vaccine coverage, and for coverage of patients who are normally required to cover part of the cost of vaccination. (A separate program called the HRSA COVID-19 Uninsured Program is available for reimbursement of vaccine-related fees for patients who aren’t covered by a health plan.) To get a claim reimbursed through the CAF, apply electronically in the CAF portal after the patient’s insurance plan denies payment to the practice. Click here to learn more.
ADA COVID-19 Practice Resources. Numerous practice resource offerings are found on this webpage from the American Dental Association. Find materials on office procedures, state regulations and more to help you continue practicing smoothly and safely throughout the COVID-19 pandemic. Click here to visit COVID-19 Practice Resources.
AAPD Billing Guidance for Personal Protective Equipment.The American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) have recently released guidance for dental practices regarding the use of COVID 19-related Personal Protective Equipment (PPE) as outlined by the Centers for Disease Control (CDC). With these new CDC recommendations comes a rise in expenses for your dental practice. Historically, normal costs related to PPE, sterilization procedures and overall universal precautions have been considered inclusive of the procedure – a practice business expense.
The AAPD recommends reporting D1999 – unspecified preventive procedure by report – as an interim solution to reporting the required additional PPE. As with all CDT codes that include “by report” in the nomenclature, a narrative is required. For more information click here.
Medicaid Updates Allow States to Recognize Increased Costs for PPE. One June 30, the Centers for Medicare & Medicaid Services (CMS) released an update to its COVID-19 Frequently Asked Questions (FAQs) for State Medicaid and Children’s Health Insurance Program (CHIP) Agencies. The update can be viewed here.
Of particular interest in the updates, states may increase Medicaid and CHIP service payment rates to recognize increases in costs associated with personal protective equipment (PPE). States have the option of increasing service rates to incorporate PPE costs or paying an add-on to a service rate for PPE costs. However, Medicaid regulations prohibit providers from charging beneficiaries for the cost of PPE and require providers to accept as payment in full the amount paid by the agency plus any deductible, coinsurance or copayment required by the plan to be paid by the individual.
The new FAQs have been integrated into the previously released COVID-19 FAQ document, found here.
COVID-19 FAQ from Medicaid. Items of particular interest in the updated Medicaid COVID-19 document include teledentistry (page 30), a greatly expanded section on financing flexibilities, including advance and retainer payments (page 40) and information on payment rates and methodologies (starting on page 42). Learn more here.
If you prefer to view a document that has only the new items, rather than the full document, click here.
Dental Benefit Guides from the ADA. The American Dental Association recently released two new dental benefit guides to address common hurdles anticipated when reopening practices.
COVID-19 Testing Codes. On April 14, 2020, the ADA Code Maintenance Committee, including AAPD representative Dr. James Nickman, unanimously voted to approve the following new CDT 2021 codes for COVID-19 testing by a dental provider.
- D0XXX antigen testing for a public health related pathogen including coronavirus
- D0XXX antibody testing for a public health related pathogen including coronavirus
The current code until CDT 2021 is implemented is:
- D0999 unspecified diagnostic procedure, by report
Use of a procedure that is not adequately described by a code. Describe the procedure.
The new codes will not be official until January 1, 2021. However, when COVID-19 testing becomes available, providers are encouraged to use these codes in their practice management systems for record-keeping and document these codes in patient records so that data collection can begin. Whether the codes can be transmitted on a claim form, and whether they will be accepted for coverage in 2020, is under review by the payers.
Protect your reputation during COVID-19. This April 15 article from Ragan’s PR Daily outlines what businesses can do to safeguard carefully developed reputations and digital presences. View the article here.