May 12, 2020
Home Health Plans of Care: NPs, CNSs and PAs Allowed to Certify
This article was originally published in the May 7, 2020 MLN Connects at https://www.cms.gov/files/document/2020-05-07-mlnc.pdf
Section 3708 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act (Pub. L. No. 116-136) amended sections 1814(a) and 1835(a) of the Social Security Act to allow Nurse Practitioners (NPs), certified Clinical Nurse Specialists (CNSs), and Physician Assistants (PAs) to certify beneficiaries for eligibility under the Medicare home health benefit and oversee their plan of care. This is a permanent change that will continue after the Public Health Emergency.
Effective for claims with dates of service on or after March 1, 2020, these non-physician practitioners may bill the following codes:
- G0179: Physician re-certification for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care
- G0180: Physician certification for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care
- G0181: Physician supervision of a patient receiving Medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans
The descriptors of the three codes will be revised at a later date to include the non-physician practitioner specialties.
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