Home health billing CPT codes G0180,G0179,G0181

How to Bill Medicare for all Home Health Eligible Claims.
Medicare provides for 3 methods of reimbursement for Physicians who
refer patients to a Medicare Certified Home Health Agency:
1. Physician Certification (Billing Code G0180)
a. Physician Certification of Home Health Plan of Care is defined as physician
services for initial certification of Medicare-covered home health services
(Form 485).
b. Reimbursement for this service is typically what Medicare pays for a level-III
visit ($50 – $60)
c. Lorian Online includes an easy process for filing and tracking Physician
Certification claims for all new referrals to Lorian Health
2. Physician Re-Certification (Billing Code G0179)
a. Physician re-certification is used when the physician signs the Plan of Care
(Form 485) to re-certify a patient for home health services. A physician will
re-certify a patient after a 60 day certification period.
b. Reimbursement for this service is typically greater than what Medicare pays
for a level-II visit but less than a level-III visit ($40-$50)
c. Lorian Online includes an easy process for filing and tracking Physician
Certification claims for all re-certified patients.
3. Physician Care Plan Oversight (CPO) (Billing Code G0181)
a. Physicians can bill for 30 minutes of Care Plan Oversight that includes
supervision of a complicated patient and requires extensive review /revision
of care plans, review of laboratory or study results, phone calls to other
health professionals, and other activities associated with the patient’s home
health care.
b. Reimbursement for this service averages approximately $100.
c. Physician needs to keep a log in the patient’s chart that shows activities and
time spent.

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