CMS lifts freestanding ER billing restrictions during pandemic

CMS issued guidance April 21 allowing independent freestanding emergency departments to provide care to Medicare patients and bill for those services during the COVID-19 pandemic. 

Under current law, independent freestanding EDs are not recognized as certified Medicare providers, meaning they cannot bill Medicare and Medicaid for services rendered. However, CMS is making an exception during the pandemic as a way to increase hospital capacity. 

Colorado, Delaware, Rhode Island and Texas are the only four states that license independent freestanding EDs to operate without a hospital affiliation. During the pandemic, those facilities may temporarily enroll in Medicare as hospitals to provide inpatient and outpatient services.

CMS said states can allow independent freestanding EDs that are not affiliated with a hospital to enroll as a Medicaid-certified clinic. 

"Expanding the number of providers available to Medicare and Medicaid beneficiaries eases some of the burden shouldered by traditional hospitals and allows the healthcare system to treat more patients at a time when capacity is often limited," CMS Administrator Seema Verma said. "We must leave no stone unturned as we seek to bolster the healthcare system during this unprecedented crisis."

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