Physician or Allowed Practitioner Billing for Certification and

30.5.4 – Physician or Allowed Practitioner Billing for Certification and Recertification (Rev. 10438, Issued: 11-06-20, Effective: 03-01-20, Implementation: 01- 11-21) Certification and recertification claims are Part B claims paid for under the Physician Fee Schedule. These claims are billed using HCPCS codes G0180 (certification) or G0179 (re-certification). The descriptions of these two codes indicate that they are used to bill for certification or recertification of patient eligibility “for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with the HHA and review of reports of patient status required by physicians or allowed practitioners to affirm the initial implementation of the plan of care that meets patient's needs, per certification period”. As noted above, these codes are for certification or recertification for Medicare-covered home health services. If there are no Medicare- covered home health services, these codes should not be billed or paid. As such, claims for certification/recertification of eligibility for home health services (G0180 and G0179, respectively) will not be covered if the HHA claim itself was non-covered because the certification/recertification of eligibility was not complete or because there was insufficient documentation to support that the patient was eligible for the Medicare home health benefit.