Coronavirus COVID-19: Coverage and Reimbursement

See below for the latest information about what hospital and health system leaders need to know regarding coverage and payment during the COVID-19 pandemic.

CARES Act Provider Relief Fund: Terms and Conditions and Basis, Formulas, and What the Funds Are to Be Used For

Updated July 1, 2020

The two documents available on this webpage provide (a) all the Terms and Conditions imposed by HHS for the various tranches included in the CARES Act and what providers retaining funds received under these tranches must do; and (b) the basis, formulas, and what the funds are to be used for in each tranche.

COVID-19 Waiver Tracker

May 8, 2020

The AHA has asked the Department of Health and Human Services to consider taking a series of actions to temporarily suspend certain requirements in order for health care providers to better respond to the novel coronavirus (COVID-19) outbreak.

AHA Resource: Summary on Medicare Coverage and Payment for COVID-19 Virtual Care

April 18, 2020

This executive summary from the AHA covers highlights from a recent CMS video providing answers to frequently asked questions about what types of virtual services Medicare covers, who can provide these services and how these services are billed.

AHA Urges Private Health Insurers to Help Hospitals and Health Systems Meet Historic Challenge to Respond to COVID-19

April 1

The AHA today urged leaders from the nation’s five largest private health insurance companies – Aetna, Anthem, Humana, Cigna and UnitedHealthCare – and organizations that represent insurers (America’s Health Insurance Plans and Blue Cross Blue Shield Association) to join hospitals and health systems to “meet the historic challenge” caused by COVID-19 to “ensure that the health care system is there for anyone who needs care.”

Health Insurers' Response to COVID-19

March 31

America’s Health Insurance Plans’ website provides information on specific actions health plan providers are taking to address COVID-19 for members.

Frequently Asked Questions Regarding ICD-10-CM Coding for COVID-19

FAQ Updated on April 28, 2020

Questions and answers jointly developed and approved by the American Hospital Association’s Central Office on ICD-10-CM/PCS and the American Health Information Management Association addressing coding for COVID-19.

Coronavirus Update: CMS Issues Information on Payment and Coverage Related to COVID-19

March 6 Advisory

AHA Advisory with the latest updates on coverage and payment for Covid-19.

COVID-19 Update: News on coverage, tests and N95 respirators

March 6 Headline Item

News from AHIP, Washington state’s insurance commissioner, CMS, LabCorp and President Trump.

Coverage and Payment Related to COVID-19 Medicare

March 5 Fact Sheet

CMS coverage and payment information for Medicare related to diagnostic tests, vaccines, inpatient hospital care services, inpatient hospital quarantines, telehealth services, and more.

Coverage and Benefits Related to COVID-19 Medicaid and CHIP

March 5 Fact Sheet

CMS information on Medicaid/CHIP benefits, cost sharing and premiums, and obtaining Medicaid/CHIP coverage.

Information Related to COVID–19 Individual and Small Group Market Insurance Coverage

March 5 Fact Sheet

CMS coverage and payment information for individual and small group market insurance coverage related to diagnostic tests, vaccines, inpatient hospital care services, inpatient hospital quarantines, telehealth services, and more.

Resource: New ICD-10-CM Code 2019 Novel Coronavirus (COVID-19)

The latest information in the international classification of diseases.

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