Telehealth Home Health Services: New G-Codes

Prior to 1/1/2023, data on telecommunications technology used during a 30-day period of care at the patient level was not collected on HH claims. Effective 1/1/2023, HHAs may begin voluntarily reporting the new telecommunications G-codes on HH claims with HH periods of care that start on or after 1/1/2023. Reporting these new codes will become mandatory with HH periods of care that start on or after 7/1/2023.

The three new codes are:

G0320 – HH services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications systems
- Report each service as a separate dated line under the appropriate revenue code for each discipline providing the service
- Report units as one per service (not in 15 minute increments)
- Report charges per the HHA’s internal policy for determining charges
G0321 – HH services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system
- Report each service as a separate dated line under the appropriate revenue code for each discipline providing the service
- Report units as one per service (not in 15 minute increments)
- Report charges per the HHA’s internal policy for determining charges
G0322 – The collection of physiologic data digitally stored and/or transmitted by the patient to the HHA (for example, remote patient monitoring)
- Report remote patient monitoring that spans a number of days as a single line item showing the start date of monitoring and the total number of days of monitoring in the units field for the billing period
- Report charges per the HHA’s internal policy for determining charges

Additional claim submission requirements:

Only report the G-codes on Type of Bill 032x with revenue codes 042x, 043x, 044x, 055x, 056x, and 057x.
Do not submit a telehealth service date as the location code (Q5001, Q5002, or Q5009) line item date on a claim. Only an in-person visit date may be reported as the first visit in the period on the 0023 revenue line and match the location code date, or the claim will return with reason code 31791.
The HHA should not submit a claim if no in-person visits were provided and only telehealth services were completed in the billing period.

These new HCPCS codes are not considered a home visit for the purposes of:

Patient eligibility or payment, per section 1895(e)(1)(A) and (B) of the Social Security Act
Outlier unit amounts sent to the HH Pricer
Calculating LUPA add-on payments
Ensuring covered skilled visit requirements are met
Review of claims with unusually high numbers of covered visits
Total visits counts and validation of the total visits counts shown in value codes 62 and 63

Collecting data on telecommunications technology use on HH claims will allow CMS to:

Analyze the characteristics of patients using services provided remotely
Have a broader understanding of the social determinants that affect who benefits most from these services, including what barriers may potentially exist for certain subsets of patients

The HHA must document the medical record to show how the telecommunications technology helps to achieve the goals outlined on the plan of care and the plan of care must describe how such technology is tied to the patient-specific needs in the comprehensive assessment.

Telehealth Home Health Services: New G-Codes

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