Wiki G0180 equivalent for commercial insurances

GosiaM

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Looking for the advice regarding:
What code should I use for signing/filling out the Home Health Certification and Plan of care when billing commercial insurance (BCBS, UHC, Aetna)? For Medicare we use G0180 (our providers are hospitalist so they sign the initial certifications only). Thank you in advance.
 
There is no equivalent code for that service; it's specifically a Medicare program/code and covered service. Some commercial payers will reimburse, and some won't. We bill the G0179 or G0180 to all payers, to be consistent for all patients and compliant. If it's not covered, our contracts with our payers will make it provider responsibility. If you bill a 94999 (unlisted E&M code), you're going to get a denial anyway.
 
There is no equivalent code for that service; it's specifically a Medicare program/code and covered service. Some commercial payers will reimburse, and some won't. We bill the G0179 or G0180 to all payers, to be consistent for all patients and compliant. If it's not covered, our contracts with our payers will make it provider responsibility. If you bill a 94999 (unlisted E&M code), you're going to get a denial anyway.
I know this is an old post, but do you know if this is still the case? Is there a code that commercial payers will reimburse for home health certifications/recertifications?
 
Still no CPT code for home health certification/recertification. You would still bill with HCPCS codes.
 
Hi Pam, Can we not bill for Home health Certification with the Care Plan Oversight services CPTs for the commercial insurances. My doctor also does Plan of Cares for commercials, what codes can be used, can Care Plan Oversights be used for Plan of Care.

Your reply is much appreciated !! Thanks in advance.
 
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