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Thread: Care Plan Oversight

  1. #1

    Default Care Plan Oversight

    AAPC: Back to School
    I was approached about billing for services when the patient is on Hospice and the physician is involved in the patient care and plan (prescriptions, communications, assessment, etc.). The physicians are employed by the hospital and work in an outpatient facility (cancer). I guess I am getting hung up on the the term "within a calendar month"; 15-29 minutes. (99377). What documentation is required to support the billing of this code and is it billed 10/1/10-10/31/10 - 99378? Does Medicare reimburse this code?
    I am very new to this and never billed any 99374-99380 codes. Any and all help will be appreciated.

  2. #2


    The code can only be billed once per 30 day time perioc and then by only one physician. I don't believe this code is on the new Medicare fee schedule. I know 99374 no longer is since home health also went to prospective payments. If the patient is in hospice and on Medicare you have to bill the Hospice. They get paid thru a PPS and any care provided has to be added to thier bill and they in turn pay you. The doctor has to document everything he does for the month and then bill that way. I think you can estimate the time he spends on each phone call, etc. but you should be careful about over estimating. This is how I understand the billing for these codes. I hope this helps.

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