Please see
below to learn about the Wyoming Medicaid response to COVID-19
and find the latest program guidance.
Additional information will be added as
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PASRR Requirement for NH & Swing Bed Providers
Telehealth Changes to COVID-19
Billing Information
Enrollment/Re-Enrollment Exception
Resources
UPDATED
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PASRR Requirements for NH & Swing Bed Providers |
In an effort to eliminate any barriers
to care that might exist in relation to the COVID-19 virus,
Wyoming Medicaid is temporarily suspending the requirement for
PASRR Level I and PASRR Level II for thirty (30) days.
All new admissions may be treated like exempted hospital
discharges.
After 30 days, new admissions with mental
illness or intellectual disability should receive a PASRR
Level I and PASRR Level II, if required.
For the safety of the clients and
staff, the PASRR Level II can be conducted remotely by
telehealth or telephonically.
Please make sure the individual remains directly involved
in the evaluation process to the fullest extent.
See the below bulletins for
additional information
Additional updates to Nursing Home and Swing Bed PASRR
Requirements 4.8.20
REVISED Nursing Facilities COVID-19 PASRR 3.31.20
Nursing Facility COVID-19 PASRR Changes 3.27.20
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Telehealth Changes for COVID-19 |
Any services that are clinically
appropriate may be billed via Telehealth. Be sure to
mark the emergency indicator for any COVID-19 services.
The GT Modifier is not an
allowed outpatient modifier for claims processing through
OPPS. Refer to Section 11.16.10 Modifiers, within the
Institutional/UB Provider Manual
for more information.
For additional information and billing
instructions refer to Chapter 6 Section 24 (Telehealth 6.24).
See below bulletins for additional
information
Home Health COVID-19 Telehealth 4.1.20
FQHC/RHC Tribal Facilities Telehealth 3.20.20
BH Peer Specialist via Telehealth 3.20.20
BH Group Therapy via Telehealth 3.18.20
Additional Resources
AAP
Guidance
AAFP Guidance
Codes
-
U07.1 - COVID-19 DX code: valid for
dates of service beginning 4/1/2020.
-
87635 - Infectious agent detection by nucleic acid (DNA or
RNA); severe acute respiratory syndrome Coronavirus 2
(SARS-COV-2) (Coronavirus Disease [COVID-19]), amplified
probe technique: valid for dates of service beginning
3/13/2020.
-
U0001 - CDC 2019-Novel Coronavirus Real-Time RT-PCR
diagnostic panel: Valid for dates of service beginning
2/4/2020.
-
U0002 - Non CDC Laboratory tests for COVID-19:valid dates
of service beginning 2/4/2020.
-
U0003 - Infectious agent detection by
nucleic acid (DNA or RNA); severe acute
respiratory syndrome coronavirus 2 (SARS-CoV2)
(Coronavirus disease [COVID-19]), amplified probe
technique, making use of high throughput probe
technologies as described by CMS-2020-01-R
-
U0004 - 2019-n-CoV Coronavirus,
SARs-CoV-2/2019-nCoV (COVID-19), any technique, multiple
types or subtypes (includes all targets), non-CDC, making
use of high throughput technologies as described by
CMS-2020-01-R
-
U0005 - Infectious agent detection by
nucleic acid (DNA or RNA); severe acute
respiratory syndrome conornaviruse. An add-on
reimbursement to U0003 and U0004 and should
only be billed if the test
result is:
- Returned within 2 calendar days of
the specimen being collected,
and
- A majority of the laboratory's high
throughput tests in the previous
calendar month were completed within 2
calendar days from specimen collection
-
A0998 - Treat and Release: valid for Ambulance taxonomies
for the duration of National and State Public Health
Emergency declarations.
-
99600 - Home visit NOS: valid for Ambulance taxonomies for
the duration of National and State Public Health Emergency
declarations.
-
G2023 - Specimen collection for severe
acute respiratory syndrome coronavirus 2 (SARS - CoV-2)
(Coronavirus disease [COVID-19]), any specimen source
-
G2024 - Specimen collection for severe
acute respiratory syndrome coronavirus 2 (SARS - CoV-2)
(Coronavirus disease [COVID-19]), from an individual in a
skilled nursing facility or by a laboratory on behalf of a
home health agency, any specimen source
-
99000 - Handling and/or conveyance of
specimen for transfer from the office to a laboratory.
This code is now open to all provider types.
-
91300 - Severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])
vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL
dosage, diluent reconstituted, for intramuscular use
-
91301- Severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])
vaccine, mRNA-LNP, spike protein, preservative free, 100
mcg/0.5mL dosage, for intramuscular use
-
90471- Immunization Administration;
1 Vaccine (Single or combination vaccine/toxoid)
-
90472- Immunization Administration;
Each additional vaccine. To be listed separately in
addition to code for primary procedure.
-
0001A - Pfizer-Biontech
COVID-19 Vaccine Administration - First Dose
-
0002A - Pfizer-Biontech
COVID-19 Vaccine Administration - Second
Dose
-
0011A - Moderna COVID-19
Vaccine Administration - First Dose
-
0012A - Moderna COVID-19
Vaccine Administration - Second Dose
-
0021A - AstraZeneca COVID-19
Vaccine Administration - First Dose
-
0022A - AstraZeneca COVID-19
Vaccine Administration - Second Dose
-
0031A - Janssen COVID-19
Vaccine Administration
Policy Exceptions
-
Ambulance covered services will be
extended to transportation of a patient, regardless of
their COVID-19 status, to a location other than the most
appropriate or closest hospital in order to prevent
overloading of a hospital or due to excess patient census.
Prior Authorization Changes
-
Rental Ventilator PA Requirement
will be
suspended for dates of service beginning 3.1.20. Codes
effected:
- E0466
- E0470
- E0471
- E0472
- E0481
-
Home Health PA requirement
suspended effective 3/17/2020
- 11/30/2020. Per the Home Health and
DME Prior Authorization Requirement
Reinstatement bulletin below this exception
ended for 12/1/2020 and forward dates of service.
-
Change Healthcare has created a new electronic prior
authorization submission portal for pharmacy prior
authorization submission. This portal can be found under
the Prescriber Information tab at
http://www.wymedicaid.org/
See below bulletins for additional information
Home Health & DME Prior Authorization
Requirement Reinstatement
COVID-19 Flier for Wyoming 4.28.20
Pharmacy Electronic PA Submission 4.4.20
Home Health Removal of PA 3.18.20
COVID-19 Testing Codes RA Banner
COVID-19 Ambulance Changes 3.27.20
Wyoming Medicaid recognizes the importance of supporting its
providers and has made the following process changes, which
will remain in effect through the COVID-19 emergency.
The goal of Medicaid is to make and keep providers active
during this hectic time to allow providers and their offices
to focus on providing services to Wyoming residents.
Medicaid's initiative requiring all current active providers
to receive electronic bank transfers (EFT) by April 1, 2020 is
still a mandate but providers will remain active if they do
not meet the date.
Medicaid is diligently working on making the necessary updates
to the provider files impacted by the COVID-19 exceptions
outlined below. We anticipate in having all the files
updated no later than 4/6/2020, at that time providers may
resubmit any denied claims meeting the criteria.
- Medicaid will be updating inactive providers to active,
if they became inactive between the dates of 1/1/2020 to
current for one of the following reasons:
- Provider failed to provide Medicaid with their
current Medicare certification (inactive status of B)
- Provider failed to provide Medicaid with their
current license or certification (inactive status of
D)
- Provider has not had any paid or denied claims
within the last 15 months (inactive status of J)
- CLIA Licenses with the end date from 1/1/2020 to
9/30/2020 will have their end dates extended to avoid
claim denials.
- Letters will still be mailed and providers are
encouraged to email their updated licenses when they
are able
- Enrollment and & Re-enrollment temporary policy changes
- Any provider that became inactive due to not
completing the re-enrollment application between the
dates of 1/1/2020 to current will be made active
- Re-enrollment letters will continue to be mailed
but providers will remain in an active enrollment
status and will not be terminated
- Enrollment/Re-enrollment supporting documentation
changes
- Copies/scanned images/faxes/emails/electronic
signatures for the following documents will be
accepted at this time:
- Provider Enrollment Certification
- Healthcare Provider Agreement (blue ink
requirement is temporarily waived)
EFT remains a requirement for all new enrolling providers.
To protect providers/vendors the State Auditor's Office (SAO)
requirements for electronic funds transfer (EFT) remain the
same:
- W9 Form - copy is accepted, but must have an original
signature, electronic signatures are not accepted.
- EFT requires one (1) of the following:
- A voided check
- Original bank letter
- Visit the SAO website for the W9 Form and any
additional questions,
https://sao.wyo.gov/vendors/
Medicaid Provider Enrollment email address is
wyenrollment@conduent.com
Wyoming Department of Health EUR Webinar
NEW
Cares Act Funding for Mental Health and Substance Abuse
Services
CMS New
Nursing Home Resource Center
AAP Critical Updates
AAP Telehealth Guidance
CDC Recommended Child & Adolescent Immunization Schedule
AAFP Telehealth Guidance
CDC Vaccine Storage & Handling Toolkit
CMS Information and Guidance Medicaid Postcard
Wyoming Medicaid 1135 Waiver Approval Letter
CMS Lessons from the Front Lines: COVID-19
On behalf of CMS Administrator Seema Verma, FDA
Commissioner Stephen Hahn, MD and the White House Coronavirus
Task Force, we invite you to join CMS Lessons from the
Front Line: COVID-19 on Friday, April 17th from 12:30 - 2 PM
EST. This call series is an
opportunity to hear physicians and other clinical leaders
share their experience, best practices, strategies, and
insights related to COVID-19.
Lessons from the Front Lines calls are held weekly on
Fridays at 12:30 PM Eastern and specific topics vary.
Dial in details are below
CMS Dial in (877) 251-0301
Access Code: 8672948
Webcast Streaming:
https://protect2.fireeye.com/url?k=6fb83c6b-33ed3578-6fb80d54-0cc47adb5650-cdbb9430fa7bc190&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=1924
Conference lines are limited, so we highly
encourage you to join via audio webcast, either on your
computer or smartphone web browser.
Getting Started with the
Provider Relief Fund WebEx
The U.S. Department of Health and Human Services (HHS),
through the Provider Relief Fund (PRF), is distributing $15
billion to eligible Medicaid, CHIP, and Dental providers.
if you are a provider who is interested in learning about the
application process for the PRF, please register and join the
webcast on July 27th. Please feel free to share the
webcast information with other providers that would be
interested in participating as well.
Presenting: Getting Started wiht the Provider Relief Fund for
Medicaid, CHIP, and Dental providers
Date: July 27th
Time: 3-4 p.m. ET
Registration Link:
https://webex.webcasts.com/starthere.jsp?ei=1348276&tp_key=fa54a9fb41
* Please pre-register to reserve a spot. This event will
be delivered via webcast, no dial in required.
Presentation materials will not be distributed.
Provider Relief Fund Health and
Human Services Press Release
Health and Human Services
sent out a press release late Friday, July 31st related to the
Provider Relief Fund. HHS is announcing an application
deadline extension until August 28, for the Medicaid/CHIP and
dentist distribution from the funds. Additionally,
starting the week of August 10, HHS will give providers who
received funds directly from the Phase 1 Medicare distribution
a second opportunity to apply for funding from the
Medicaid/CHIP and dentist distribution to allow those
providers to access funding up to 2% of annual patient
revenue.
See the full press release here
https://www.hhs.gov/about/news/2020/07/31/hhs-extends-application-deadline-for-medicaid-providers-and-plans-to-reopen-portal-to-certain-medicare-providers.html
HHS Additional Relief Fund Distribution
Clinicians
that participate in State Medicaid
who have not yet received funding may submit their annual
patient revenue information to the Medicaid and
Chip Targeted
Distribution Provider Relief Fund Payment Portal. This
funding will supply relief to Medicaid providers experiencing
lost revenue or increased expense due to COVID-19. Refer
to the complete notification for the complete details and
requirements.
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