Hospitals will get a payment boost on Sept. 1 for caring for Medicare beneficiaries diagnosed with COVID-19. A positive COVID-19 laboratory test must be documented in the patient's medical record for the hospital to receive the higher payment, CMS announced Aug. 17.
Four things to know:
1. Hospitals will get a 20 percent Medicare pay bump for patients diagnosed with COVID-19, according to Bloomberg Law.
2. To receive the payment boost, the COVID-19 test must be taken within 14 days of the hospital admission. Only the results of viral testing that are consistent with CDC guidelines can be used. "In the rare circumstance where a viral test was performed more than 14 days prior to the hospital admission, CMS will consider whether there are complex medical factors in addition to that test result for purposes of this documentation requirement," CMS said.
3. Tests performed by an entity other than the hospital, such as a local government-run testing center, can be manually entered into the patient's medical record.
4. CMS may conduct post-payment medical review to confirm a positive COVID-19 laboratory test. If there isn't a positive test in the patient's medical record, CMS will recoup the 20 percent payment increase.