Medicare Claims Processing Manual (Pub. 100-04), Ch. 10 § 20.2.5

No NOA Received and Therapy Services Rendered in the Home

Last amended: 2021Year: 2021Length: 146 wordsOfficial source
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.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 10 § 20.2.5: No NOA Received and Therapy Services Rendered in the Home | Justis AI