Information

INFORMATION FOR PHYSICIANS: (Please note: Basic Non-Medical Home Care is NOT covered by Medicare and is NOT prescribed by a physician)

Physician involvement in home care is critical, especially since the home care population has been becoming increasingly frail with more complex health care needs.

Physician Payment for Home Care Cert and Recert

Rates and Information Applicable as of 2002

(CMS) Center for Medicare and Medicaid Services started to pay physicians for Cert and Recert of Medicare Home Health Care patients as of January 01, 2001. Depending on geographic locations, such payments average (Check current CMS rates) for certification and (Check current CMS rates) for recertification.

According to Department of Health and Human Services On January 1, 2001, the national average payment rose from (Check current CMS rates) to (Check current CMS rates).

HCPCS Codes for Physician Home Care Certification / Re-certification

GO180 Cert = Initial Certification of Medicare Home Health Care

  • This code may only be used when the patient has not received Medicare covered home health services in the last 60 days.
  • Average Payment = (Check current CMS rates)
  • One bill per patient per 60 day episodes of care
  • Applicable ONLY to NEW orders of Medicare Skilled Home Health Care

G0179 Recert = Re-certification of Medicare Home Health Care

  • This code may be used after a patient has received services for at least 60 days (or one certification period) after the initial certification. In most instances this code may only be billed once every 60 days.
  • Average Payment = (Check current CMS rates)
  • On the average occurs per 60 days.
  • Not applicable for order changes

G0180 Certification and GO179 Re-certification:

  • Can only be billed by physician who authorizes Home Health Care
  • Not for Durable Medical Equipement, Outpatient Physical Therapy, Medicaid services.
  • Billed under Medicare Part B, requiring physicians to bill co-payment.
  • No additional documentation of claim necessary. Verbal orders and 485 Plan of Care provided for the physician to sign.

GO181 = Home Health Care Supervision- Average Payment = (Check current CMS rates)

  • On the average occurs per 60 days.
  • Not applicable for order changes