Why and when to use Modifier CS

Question:

Why and when should we use modifier CS?

Answer:

Use modifier CS on visits related to testing for COVID-19.

Modifier CS: cost sharing waiver for COVID-19 testing

When you do, Medicare and private insurers will pay 100% of the claim, without any patient due cost sharing. The two laws that were passed require Medicare and commercial plans to cover these services without any cost sharing requirements or prior authorization or other medical management requirements.

Although the information about the modifier was released in April, it is retroactive to March 18, 2020.

You can use modifier CS on both in-person visits and visits via telehealth. If using modifier 95, for telehealth services, I suggest reporting it like this: 99214 -CS -95. Modifier CS affects payment, so use it first. Modifier 95 is informational.

It is not for use when treating Covid, unfortunately.

You can read more about modifier CS here.

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