New Jersey Expands the Use of Antigen Testing for Surgery Centers and Long Term Care Facilities, CMS Adds New Telehealth Codes, and Additional HHS Guidance on the Provider Relief Fund

For more information about this blog post, please contact Khaled J. KleleRyan M. MageeLabinot Alexander BerlajolliBrianna J. Santolli, or Daniel J. Parziale.

Revised New Jersey Executive Directive No. 20-016 Modifies Testing Protocols for Ambulatory Surgery Centers to Allow Antigen Tests

The New Jersey Department of Health has modified its previous guidance on the resumption of elective surgeries and invasive procedures in Ambulatory Surgery Centers (“ASCs”) to allow antigen tests to satisfy the requirement that patients undergo COVID‑19 testing and receive results within six days before their scheduled surgery. As explained in our prior blog post from August 2020, the type of permissible COVID-19 testing that was previously allowed was limited to molecular tests, such as the RT-PCR test. Now, antigen tests can be used. Most point of care tests, (i.e. rapid tests) are antigen tests. Antibody tests, which determine whether or not antibodies to COVID-19 are present, still may not be used. The remaining provisions under the guidance are unchanged.

This is consistent with the New Jersey Department of Health’s recent executive directive allowing antigen testing as a permissible alternative to molecular diagnostic tests in helping long term care facilities to fulfill their weekly testing requirements.

CMS Expands Medicare Coverage for Telehealth Services and COVID-19 Diagnostic Testing

Centers for Medicare & Medicaid Services (“CMS”) recently added 11 new services to the list of telehealth services reimbursable by Medicare during the COVID-19 public health emergency (“PHE”). Effective immediately, Medicare will begin paying eligible practitioners who furnish these newly-added telehealth services for the duration of the PHE. 

CMS also announced new actions to pay for expedited COVID-19 test results. Beginning January 1, 2021, Medicare will lower the base payment amount to $75 for COVID-19 diagnostic tests run on high‑throughput technology in accordance with CMS’s assessment of the resources needed to perform those tests. Also starting January 1, 2021, Medicare will make an additional $25 payment to laboratories for a COVID-19 diagnostic test run on high‑throughput technology if the laboratory: (a) completes the test in two calendar days or less; and (b) completes the majority of their COVID-19 diagnostic tests that use high throughput technology in two calendar days or less for all of their patients (not just their Medicare patients) in the previous month. 

Hospitals Cannot Use CARES Act Grants to Repay Medicare Loans

The Department of Health and Human Services has updated an FAQ document to clarify that hospitals cannot use COVID-19 provider relief funds distributed under the Coronavirus Aid, Relief and Economic Security Act (“CARES Act”) to repay payments made under the CMS Accelerated and Advance Payment Program. The updated FAQ was issued in response to CMS’s October 8, 2020 news release, which incorrectly stated that hospitals could use CARES Act funds to repay Medicare loans.