Question Injection given in patient's home

Messages
33
Location
anchorage, AK
Best answers
0
The office I work for (outpatient behavioral health) is planning to start having nurses go to patient's homes to administer psychiatric medication injections. Is this billable as "incident to" since the provider is not in the building where the patient is having the injection done? If not, is this billable at all? I have no clue about how home health visits work.
 

SharonCollachi

True Blue
Messages
2,178
Location
Clovis, CA
Best answers
3
This isn't "home health", so anything you search for on that will not give you what you need. This is a medical service at home. It is not incident-to, as the physician is not on site, as you noted.

Is the nurse of a license level and credential level that they can bill under their own name? Can they see a patient in the office if the doctor is not in the building?

Are you doing this because of COVID or is there another reason the patient cannot come in to the office?

Here is some info: https://med.noridianmedicare.com/web/jeb/specialties/em/home-and-domiciliary-visits
 
Messages
33
Location
anchorage, AK
Best answers
0
This isn't "home health", so anything you search for on that will not give you what you need. This is a medical service at home. It is not incident-to, as the physician is not on site, as you noted.

Is the nurse of a license level and credential level that they can bill under their own name? Can they see a patient in the office if the doctor is not in the building?

Are you doing this because of COVID or is there another reason the patient cannot come in to the office?

Here is some info: https://med.noridianmedicare.com/web/jeb/specialties/em/home-and-domiciliary-visits
The reason we are doing this is the organization I work for has created what is called an ACT team that provides psychiatric and case management type services outside of the office setting. What type of credentials would a nurse need to bill under their own name?
 

thomas7331

True Blue
Messages
3,771
Best answers
11
As I understand it, if the physician is not going to be physically present at the patient's home to supervise, then the nurse's service would not meet 'incident to' requirements and cannot be billed, at least to Medicare and payers that follow those guidelines. But beyond that, it's even possible that it could be outside the nurse's scope of practice under state law to perform this without direct supervision.

Really this is a home health nursing service that you are describing here and I'd suggest your practice may want to be look into your state's regulations on home health services to find out whether or not you need to become licensed or credentialed as a home health provider in order to offer this.
 
Last edited:
Top