Home Care Certification and Recertification

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GO180 Initial Certification of Medicare Home Health Care

• Date of service is date plan of care was signed by physician
• Must include home health agency’s 6 digit provider number
• Only the physician who authorizes the home health care may bill for the service.
• One bill for initial certification per patient 60 day episode.
• Note: Initial certification cannot be billed again unless patient has gone more than 60 days without homecare and then begins another episode of care.
• Maintain a signed copy of the initial plan of care as documentation of the service provided

GO179 Recertification of Medicare Home Health Care

• Date of service is date recertification plan of care was signed by physician
• Must include home health agency’s 6 digit provider number
• Only the physician who authorizes the home health care may bill for the service.
• May bill once per 60 day recertification episode of home health care services.
• Maintain a copy of each 60 day recertification plan of care as documentation of the service provided

G0181 Care Plan Oversight (CPO)

• Physician supervision of patients under either the home health or hospice benefit.
• Patient must require complex or multidisciplinary care modalities requiring ongoing physician involvement.
• Medicare does not pay for care plan oversight for nursing facility or skilled nursing facility patients
• Dates of service are the first and last dates during which documented care plan services were actually provided during the calendar month. (Not the first and last calendar date of the month in which the claim is submitted.

For additional details on documentation and claim submission please Click Here.