Care Plan Oversight Services

March 1st, 2017 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Categories:   CPT® Coding   Home Health|Hospice   Billing  
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Care Plan oversight services are commonly done but rarely billed. The following codes can only be billed once every 30 days. The use of the following codes are determined by the complexity and approximate time spent by the physician or other healthcare professional within a 30-day period.

G0179 MD re-certification HHA PT May be submitted per certification period
G0180 MD certification HHA patient May be submitted per certification period
G0181 Home health care supervision Requires 30 minutes or more of physician or NPP's time within a calendar month       
G0182 Hospice care supervision Requires 30 minutes or more of physician or NPP's time

NOTE: Medicare does not pay for care plan oversight services for nursing facility or skilled nursing facility patients. 

CPO: Home Health

Medicare pays separately for the services involved in physician certification/re-certification and development of a plan of care for Medicare-covered home health services when certain criteria are met.

Special notes regarding certification and re-certification of home health care:

CPO: Hospice

Submit HCPCS code G0182 for CPO services provided to patients that have elected hospice benefits under Medicare and who are in a Medicare-approved hospice.

For criteria for coverage, documentation, and billing requirements please review your carriers policy:

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