Permanent Home Health Rules Change in 2020
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Through the CARES Act, the Centers for Medicare & Medicaid Services (CMS) enacted a permanent change to the Home Health rules. The changes now allow NPs and PAs to certify and perform Home Health supervision or certification. Previously, only physicians could bill for these services. Effective for claims with dates of service on or after March 1, 2020, Nurse Practitioners (NPs), certified Clinical Nurse Specialists (CNSs), and Physician Assistants (PAs) may bill the following codes:
- G0179: Physician re-certification for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care. Arizona Medicare rate is $40.39 (MD/DO); $34.33 (NPP) (This is for the provider recertifying every 60 days). A copy of the signed 485 form should be in the chart.
- G0180: Physician certification for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care. This is for the provider’s initial certification. Arizona Medicare rate is $52.75 (MD/DO); $44.84 (NPP). A copy of the signed 485 form should be in the chart.
- G0181: Physician supervision of a patient receiving Medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans. This one requires 30 calendar minutes a month of the provider documenting on a daily basis what they were doing, regarding the patient’s HHA services. Arizona Medicare rate is $106.72 (MD/DO); $90.71 (NPP).
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Section 3708 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act (Pub. L. No. 116-136) amended sections 1814(a) and 1835(a) of the Social Security Act.
This posting is informational only, general in nature, and does not cover all situations or all rules and policies. This content is not intended to instruct medical providers on how to use or bill for healthcare procedures. A determination of medical necessity is a prerequisite North Star Medical Consulting assumes will have been made prior to assigning codes or requesting payments.