Provider Alert! Modifier CS: cost sharing for COVID-19 testing and visits

Provider Alert! Modifier CS: cost sharing for COVID-19 testing and visits

Date: August 11, 2021

Attention: All Providers

Effective Date: July 27, 2021

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: Modifier CS is not allowable when submitting a Medicaid or CHIP claim related to COVID-19 testing and visits related to testing.

How this impacts providers: Providers that bill with Modifier CS for all TCHP lines of business will deny with message “invalid; used for Medicare/Commercial Only”. This is effective July 27, 2021, when the modifier CS is populated in any position on the claim.
Sources:

https://codingintel.com/modifier-cs-cost-sharing-for-covid-19-testing-and-visits-related-to-testing/

https://codingintel.com/why-and-when-to-use-modifier-cs/

Next steps for providers: Providers should share this communication with their billing staff.

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.

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