Personal care home visits

cooper1

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We have a physician who is going to a personal care home and we are having problems with the codes. It's not a nursing home or rest home. I thought we should use codes 99324-99337 or someone had thought maybe we should be using 99341-99350..Anyone bill for personal care homes now and what codes do you use? Also what are you using for the place of service?

TIA

Tracey
 

RebeccaWoodward*

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The CPT codes 99341 through 99350, Home Services codes, are used to report E/M services furnished to a patient residing in his or her own private residence (e.g., private home, apartment, town home) and not residing in any type of congregate/shared facility living arrangement including assisted living facilities and group homes. The Home Services codes apply only to the specific 2-digit POS 12 (Home). Home Services codes may not be used for billing E/M services provided in settings other than in the private residence of an individual as described above.

http://www.cms.gov/manuals/downloads/clm104c12.pdf

30.6.14

Also...

http://www.cms.gov/mcd/viewarticle.asp?article_id=19237&article_version=2&show=all
 

ladymmc

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I thought htis might help.

http://www.cms.gov/mcd/viewarticle.asp?article_id=19237&article_version=2&show=all

CPT codes 99321 through 99333 are used to report Evaluation and Management services provided to residents in a domiciliary, rest home (e.g., boarding home), or custodial care facility which provides room, board, and other personal assistance services, usually on a long-term basis. These facilities are often referred to as adult living facilities or assisted living facilities with POS 33 (Custodial Care Facility) or POS 55 (Residential Substance Abuse Facility).
 
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