Covid-19 Use of Catastrophe/Disaster Related Modifiers (CR and DR)

Date: June 3, 2020

CMS has issued several blanket waivers, flexibilities and modifications to existing deadlines and timetables that apply through the COVID-19 public health emergency (PHE).  On June 1, 2020, a revised MLN Matters Special Edition was published, addressing the use of disaster relief modifiers to prevent gaps in access to care for Medicare beneficiaries impacted by this PHE.

Modifier DR (disaster related) is used for institutional billing, while modifier CR (catastrophe/disaster related) applies to both institution and non-institutional claims.  This includes claims for post-cataract eyeglasses submitted to Medicare’s DMEPOS.  The table contained in this notice lists a variety of situations requiring either modifier CR or DR.  Optical dispensaries that submit DME claims should be aware of this entry regarding modifier CR, but it is not likely to apply frequently.

During the current PHE, patients may be unable to visit your optical dispensary to pick up eyeglasses. There are already methods for obtaining proof of delivery when post-cataract eyeglasses must be mailed to a patient. The tracking information provided by a shipping service such as the US Postal Service, Federal Express or United Parcel Service becomes proof of delivery.   Examples include the delivery service’s package identification number linked to your invoice number.  We recommend that you include a business reply card for the patient to sign and mail back to you.  Either the shipping/mailing date or the actual delivery date may be used as the date of service.  Be sure to retain the proof of delivery documentation for the required 7 years.

Refer to Corcoran Consulting Group’s monograph, Medicare Reimbursement for Post-Cataract Eyeglasses, for additional information on proof of delivery requirements.

Just as a reminder, no Medicare DMEPOS claim is submitted for post-cataract eyeglasses dispensed to patients resident in a skilled nursing facility (SNF) under a Part A stay.  The facility is billed for these items, or hold delivery until the patient has been discharged from the SNF.

We are available and happy to assist you with issues such as this and other topics related to eye care during this public health emergency.  Stay safe.

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