Year in Review: Most Read Revenue Cycle Management Stories of 2020

AMA Adds CPT Codes for Multi-Virus Tests for COVID-19, Flu

As providers battled COVID-19 coming into the 2020 flu season, the American Medical Association (AMA) added two new codes to the Current Procedural Terminology (CPT) code set for documenting the use of multi-virus tests that can detect both COVID-19 and other viruses, like the flu.

Multi-virus tests boost testing capacity for the healthcare industry, which has faced a shortage of testing supplies, Susan R. Bailey, MD, AMA president, said at the time.

Congress Passes CARES Act Giving $100B in Hospital Funds for COVID-19

In March, Congress passed the most comprehensive COVID-19 stimulus package of the year. The Coronavirus Aid, Relief and Economic Security (CARES) Act earmarked $2 trillion for relief efforts, including $100 billion in direct payments to providers.

Subsequent legislation would add to the financial relief given to providers, including a $175 billion Provider Relief Fund. But the CARES Act remains as the primary source of federal funding for COVID-19 relief.

How Much Will the COVID-19 Pandemic Cost Hospitals?

With the number of COVID-19 cases rising exponentially in March, hospitals began to worry about how the pandemic would impact their bottom line, and more importantly, their ability to stay open. The article explores several early datasets quantifying the financial impact COVID-19 would have on hospitals.

Hospitals now have a better understanding of how much COVID-19 has cost them, but the ongoing pandemic will have a financial impact for years to come.

Hospital Stimulus Funds to Pay for Uninsured COVID-19 Treatment

Providers were not the only industry to be impacted financially by the COVID-19 pandemic. Many Americans experienced unemployment or some type of job disruption this year, and this led to shifts in payer mix for many providers.

HHS attempted to help providers by using money from the CARES Act to pay for COVID-19 treatment of the uninsured. Those funds can now also be used for provider reimbursement for COVID-19 vaccines given to uninsured patients.

CMS Releases Medicare Reimbursement Details for COVID-19 Tests

Early in March, CMS released a pricing list for COVID-19 diagnostic tests that included payment allowances for laboratories testing patients for the virus. The announcement was one of the first around what Medicare would pay providers for the testing, treatment, and now vaccination of COVID-19.

How COVID-19 Is Impacting the Healthcare Revenue Cycle

The COVID-19 pandemic has not only been an unprecedented public health emergency, but it also quickly turned into a financial crisis and eventually recession in the US. This has greatly impacted the entire revenue cycle, from coding and charging for services related to a completely new virus to collecting from patients during an uncertain time and allocating resources appropriately.

The article explores how COVID-19 initially impacted the revenue cycle and its potential to leave a lasting mark on its management.

New CPT Code Expands COVID-19 Coding, Billing to Antigen Tests

Medical billing and coding was a hot topic in 2020 as providers navigated new codes, treatment options, and reimbursement policies.  AMA’s announcement about CPT code 87426 particularly piqued provider interest.

The code allows providers to document the administration of antigen tests, which detect whether a patient has antibodies against a virus. The code is not specific to COVID-19, but has been leveraged widely by providers to fill testing gaps during the year.

Hospital Reimbursement for Uninsured COVID-19 Cases May Total $42B

Following the news that the government would reimburse providers for COVID-19 care for the uninsured, the Kaiser Family Foundation found that hospital reimbursement for that care could total up to $42 billion, or about 40 percent of the original $100 billion designated for the Provider Relief Fund.

Over 28,000 providers have received some of this funding, and HHS will extend the program to the vaccination of uninsured individuals early next year.

What Providers Need to Know About COVID-19 Coding and Billing

Coding and billing concerns were one of the top trends this year for RevCycleIntelligence readers and this article has led the pack. On top of clinical and operational concerns, providers were worried about how they would get paid for delivering the above-and-beyond services they were providing patients during the pandemic.

From changing reimbursement policies and regulatory waivers to new codes and documentation requirements, this article explores the key considerations for coding and billing COVID-19 treatment.

CMS Releases Medicare Payment Rates for COVID-19 Test CPT Codes

The most-read story on RevCycleIntelligence in 2020 was about how much CMS pays providers for administering COVID-19 tests. Robust testing has been a key strategy for fighting the virus, and with the creation of the appropriate CPT codes, providers started billing payer partners for executing the crucial component of the strategy.

Since then, CMS has announced more Medicare reimbursement rates and accepted codes for COVID-19 treatment and vaccination.