home health certification

Q
What requirements must be met to bill Medicare and other insurers for home health certification and recertification (G0179 and G0180)?

A
To bill Medicare for the services described by codes G0179 and G0180, you must meet the Centers for Medicare & Medicaid Services' guidelines. For G0180, the patient must not have been under home health care for at least 60 days. You should document your time spent developing care plans, reviewing subsequent reports of the patient's status, reviewing lab tests or other study reports, communicating with health care providers not in your practice who are involved in the patient's care, and integrating new information into the patient's treatment plan or adjusting medical therapy. Each certification period is 60 days.

Note that where other payers are involved, you should report these services with care plan oversight codes 99374 and 99375, because most private payers won't provide reimbursement for G codes