Frequently Asked Questions

What are the criteria for admission to home health care?

• The patient is homebound.
• The patient is in need of health care that requires skilled nursing or physical, occupational, or speech therapy on an intermittent basis.
• The primary care physician must sign the initial plan of care.

Which patients benefit from home care?

• Patients recovering from an illness, injury, or surgery
• Patients who are disabled
• Patients who have a chronic or terminal illness
• Patients recovering from or having experienced cva, heart attack, heart surgery, hypertension, cancer, diabetes, lung disease, congestive heart failure, etc.

When are patients eligible for hospice care?

• The physician determines that the patient has a life expectancy of 6 months or less.
• The patient agrees to accept hospice care rather than curative treatement.
• The primary care physician must sign the initial plan of care.

When should private duty in-home care be recommended?

• The patient has difficulty with activities of daily living.
• The patient has expressed concerns about safety, loneliness or desire for companionship.
• The patient is unable to drive or has difficulty getting to appointments.

How do physicians bill medicare for home health?

• Care Plan Oversight (CPO) reimbursement allows physicians to bill Medicare for their time overseeing the care of home health patients - Reimbursement Code G0181
• In 2001, Medicare began reimbursing physicians for certifying and re-certifying patients for home health care services. Use the following codes:
  • Reimbursement Code for Home Health Certification is G0180
  • Reimbursement Code for Home Health Re-Certification is G017