Medicare Claims Processing Manual (Pub. 100-04), Ch. 10 § 20.2.5
No NOA Received and Therapy Services Rendered in the Home
20.2.5 - No NOA Received and Therapy Services Rendered in the Home
(Rev. 10758; Issued: 05-11-21; Effective: 01-01-22; Implementation: 08-11-21)
There may be situations in which a beneficiary is under a home health plan of care, but
CWF does not yet have a record of either an NOA or a home health claim for the period
of care. To help inform independent therapy providers billing professional claims to
Medicare contractors that the services they rendered in the home setting may be subject
to consolidated billing, providers will receive notification on the remittance advice when
Medicare pays them for the service.
Medicare systems processing professional claims will provide this notification when the
place of service on the claim is “12 home,” the HCPCS code is a therapy code subject to
home health consolidated billing and CWF has not returned a message indicating the
presence of an NOA.