Q: How many days can a provider come to your home weekly and how many hours do they stay?
A: Home health agencies are not under any restrictions for frequency or duration of home visits. Usually visit frequencies are set initially in the nursing care plan approved by the attending physician. Home health agencies are reimbursed in episodic payments for all nursing care given within 60 days.
Question: Can a physician’s assistant (under supervision of an MD) bill for G0180?
Answer: Certification G0180 is the initial certification of a patient for Medicare-covered home health services. This code is used when the patient has not received Medicare-covered home health care for at least 60 days. The work this certification process requires includes: ordering the plan of care, signing the 485, and documenting the face-to-face encounter. Only physicians are allowed to bill for initial Certification and Recertification billing, however physician assistants, as well as nurse practitioners, may provide care plan supervision (G0181/G0182) services if they meet certain criteria. Physician assistants and nurse practitioners get reimbursed at 85 percent of an MD scheduled rate.
Question: Do you know where I can find the reimbursement rates by state for CPO?
Answer: Amedisys has published a useful guide about care plan oversight, which includes reimbursement rates by state and region. To download this guide, go here