Medicare Claims Processing Manual (Pub. 100-04), Ch. 10 § 100

Temporary Suspension of Home Health Services

Last amended: 2021Year: 2021Length: 178 wordsOfficial source
100 - Temporary Suspension of Home Health Services (Rev. 10758; Issued: 05-11-21; Effective: 01-01-22; Implementation: 08-11-21) A physician may suspend visits for a time to determine whether the patient has recovered sufficiently to do without further home health services. When the suspension is temporary (does not extend beyond the end date of the 60-day certification period) and the physician later determines that the services must be resumed, the resumed services are paid as part of the same or subsequent 30-day period of care and under the same plan of care as before. The admission date remains the same on any claims. No special indication need be made on the claim(s) for the period of suspended services. Explanation of the suspension need be indicated only in the medical record. If the suspension extends beyond the end of the current 60-day certification, HHAs must submit a discharge claim. Full payment will be due for the period of care. If the beneficiary resumes care, the HHA must establish a new plan of care and submit an NOA for a new admission.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 10 § 100: Temporary Suspension of Home Health Services | Justis AI