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Posting Date: 12/30/2022
Telehealth Home Health Services
Telehealth Home Health Services 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. On 7/1/2023 reporting telecommunications G codes became [...]
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Posting Date: 05/19/2022
Home Health Third Party Liability Demand Billing
Home Health Third Party Liability Demand Billing Table of Contents Background What is a Demand Bill? Requirements for Submission How to Submit a TPL Demand Bill Claim Page 1: Claim Page 2 – Covered and Noncovered Charges Claim [...]
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Posting Date: 05/19/2022
Billing the Home Health Period of Care Claim - PDGM
Billing the Home Health Period of Care Claim – PDGM Table of Contents Billing the Home Health Period of Care Claim – PDGM Claim Page 1: Claim Page 2: Claim Page 3 Claim Page 4 Claim Page 5 Related Resources [Return to Top] [...]
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Posting Date: 12/05/2017
Disposable Negative Pressure Wound Therapy Services Under Home Health
Disposable Negative Pressure Wound Therapy Services Under Home Health Effective for services furnished on or after 1/1/2017, Medicare will make separate payment to HHAs for dNPWT services for patients under the home health benefit. NPWT [...]
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Posting Date: 05/19/2022
Home Health Demand Billing
Home Health Demand Billing Table of Contents Background What is a Demand Bill? Requirements for Submission How to Submit a Demand Bil Claim Page 1: Claim Page 2: Covered and Noncovered Charges Claim Page 2: All Noncovered Charges [...]
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Posting Date: 01/13/2022
Billing the Home Health Notice of Admission via DDE
Billing the Home Health Notice of Admission via DDE Table of Contents Billing the Home Health Notice of Admission via DDE NOA Claim Page 1 NOA Claim Page 4 Notes Related Content [Return to Top] Billing the Home Health [...]
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Posting Date: 05/09/2022
Home Health Agency Transfer and Dispute Protocol
Home Health Agency Transfer and Dispute Protocol Specific protocol and steps must be followed prior to opening an admission period for a new patient. Step One: Verify the patient’s eligibility You must ensure the patient is not [...]
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Posting Date: 07/21/2022
Late Notice of Admission - The Exception Process
Late Notice of Admission - The Exception Process Table of Contents Timeliness of the NOA and the Penalty Requirements for Submission of the NOA Exception Process Canceling a Timely NOA to Correct an Error Reasons Not to Cancel an NOA [...]
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Posting Date: 05/09/2022
Home Health Transfers
Home Health Transfers Table of Contents Background What To Do As a Receiving HHA What To Do As the Initial HHA What To Do In Case of a Dispute Related Content [Return to Top] Background A home health transfer occurs when a [...]
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Posting Date: 02/26/2016
Reporting Home Health Periods with No Skilled Visits
Reporting Home Health Periods with No Skilled Visits Eligibility for the Medicare HH benefit requires that the beneficiary have a need for intermittent skilled nursing care, PT, SLP, or a continuing need for OT. The need for skilled care makes [...]
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Posting Date: 12/20/2016
Reporting Site of Service Codes for Home Health Care
Reporting Site of Service Codes for Home Health Care HH PPS claim payments are based on the site of the beneficiary’s care. In order for Medicare to accurately capture where home health services are provided, HHAs are required to report the [...]
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Posting Date: 04/11/2017
Billing G-Codes for Therapy and Skilled Nursing Services
Billing G-Codes for Therapy and Skilled Nursing Services Table of Contents Billing G-Codes for Therapy and Skilled Nursing Services What You Need to Know to Bill Physical Therapy Occupational Therapy Speech Language Pathology [...]
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Posting Date: 09/23/2015
Completing the Advance Beneficiary Notice for Home Health Agency Demand Claims
Completing the Advance Beneficiary Notice of Noncoverage for Home Health Agency Demand Claims The purpose of the ABN is to appropriately notify a Medicare beneficiary of services that the HHA believes Medicare will not cover. In order for the [...]
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Posting Date: 02/04/2022
Notice of Admission Questions and Answers
Notice of Admission Questions and Answers Medicare requires HHAs to submit a one-time NOA instead of RAPs for new admissions starting on or after 1/1/2022. HHAs shall no longer submit RAPs, TOB 0322 for any HH periods of care with a “From” [...]
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Posting Date: 12/16/2020
The Medicare Home Infusion Therapy Benefit and Home Health Agencies
The Medicare Home Infusion Therapy Benefit and Home Health Agencies If you are a HHA that wants to provide and bill Medicare HIT professional services starting in CY 2021, you are required to enroll with the Part B Medicare Administrative [...]
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Posting Date: 07/24/2017
Home Health Therapy Billing
Home Health Therapy Billing Table of Contents Home Health Therapy Billing 32X TOB: Billing Therapy Under a Home Health Plan of Care Discipline Revenue Codes (UB-04 FLs 42-43) Discipline HCPCS Codes (UB-04 FL 44) Service Units [...]
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Posting Date: 08/13/2020
How to Get Started - Five Easy Steps
How To Get Started – Five Easy Steps Contact your vendor, clearinghouse or billing service to ensure they support the electronic attachment program which includes the following: 6020 version of the 275 transaction; HL7 CDA R2 [...]
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Posting Date: 07/09/2020
Participating Clearinghouses and Vendors
Participating Clearinghouses and Vendors The following entities support electronic attachments with NGS. Any of these entities can assist you with implementing electronic attachments and participating in the NGS Attachment Program. [...]
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Posting Date: 03/01/2022
Benefits of Electronic Remittance Advice
Benefits of Electronic Remittance Advice Table of Contents Benefits of Electronic Remittance Advice There Are Several Benefits to Choosing ERA Versus SPR Help Interpreting the ERA Is Available [Return to Top] Benefits of Electronic [...]
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Posting Date: 08/10/2023
Duplicate Claim Editing Information
Duplicate Claim Editing Information National Government Services implemented a Part A duplicate claim edit in our EDI front-end processing system. Providers are notified that a claim is a duplicate upon receipt of the 277 Claims [...]
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