MedCost Benefit Services, a third-party claims administrator for MedCost, LLC, has amended its claims processing procedures for COVID-19 testing related services. Effective for dates of service on or after September 1, 2020, providers must submit appropriate coding for COVID-19 testing related services for any claim submission. This requires the use of modifier CS in the first position on any COVID-19 related services that result in an order or administration of a COVID test. This may include but is not limited to physician office visits, labs, or diagnostic imaging, as described in the MedCost Benefit Services Medical Policy. The actual COVID-19 test does not require the use of the modifier. The modifier should only be used for services when determining if a COVID-19 test is required. Using the appropriate modifier ensures that correct benefits, with no member cost sharing, are applied. If the CS modifier is not present in the first position, benefits will be applied based on the patient’s plan design which might cause patient responsibility. Please refer to the MedCost Benefit Services Medical Policy for more detailed information. Note: This update only applies to plans administered by MedCost Benefit Services.
Updated April 25, 2022