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Home Health Care News

Things Your Agency Should Be Doing To Stay Safe During the COVID-19 Pandemic On New Year’s Day, the Wall Street Journal reported the latest, emerging COVID-19 virus variants. Meanwhile, many countries face a second surge of coronavirus infections. This startling news leaves many agency owners and...

Shelter-in-Place. Self-quarantine. Telehealth. Work-from-home. Zoom Meetings.  Microsoft Teams. Google Hangouts. Conference Calls.  Limited gatherings. COVID-19. Today’s home healthcare seems to reflect all the above changing work environments. We have seen the impact on patient care and the quick implementation of telehealth visits for home health in the name of flattening the curve, but the impact of COVID-19 goes beyond our patients. 

On November 4, 2020 the Centers for Medicare and Medicaid Services (CMS) published the final rule for 2021. Overall the changes this year were minimal since this was the first year for the Patient-Driven Groupings Model (PDGM) and there is not enough data to support significant changes. Furthermore, the COVID pandemic affected industry operations which mitigated reform to the PDGM payment structure. Agencies should review the changes affecting their operations from the fifty-nine-page rule, but here is a quick glance at the updates:

States may be complicating non-physician certifications in home health care, as hospitalizations and homecare needs rise. In this edition of the Homecare Software blog...the CARES Act has made it possible for nurse practitioners, physician assistants, and clinical nurse specialists to certify eligibility for home health. This has facilitated movement in the home health care industry towards eliminating Medicare’s rigid physician certification requirements and policies. Congress first warmed to the idea of allowing non-physician certification in the early spring just as the COVID-19 pandemic was beginning to surge. At the end of the day, in spite of the federal government’s efforts, states by law have the final say when it comes to making these overtures into reality.

The worldwide Coronavirus pandemic has caused ripple effects across numerous sectors of the global and local economies. A dramatic shift upwards in demand for homecare and medical care in general, has subsequently changed the way that healthcare is delivered and received on many fronts.

Can home health care agencies bill Medicare Part B for outpatient services? 

 

Outpatient Therapy Services BillingYes. According to CMS, outpatient therapy services may be provided by a home health agency to patients who are not homebound or otherwise are not receiving services under a home health plan of care (POC). These services are not paid under the Home Health Prospective Payment System (HH PPS). The reimbursement for the outpatient therapy services is calculated using the Medicare Physician’s Fee Schedule (MPFS).