Completion of Form CMS-1450 for Home Health Agency Billing

40 - Completion of Form CMS-1450 for Home Health Agency Billing (Rev. 3021, Issued: 08-08-14, Effective: 01-01-12, Implementation: 09-08-14) The Social Security Act at §1862 (a)(22) requires that all claims for Medicare payment must be submitted in an electronic form specified by the Secretary of Health and Human Services, unless an exception described at §1862 (h) applies. The electronic form required for billing home health services is the ASC X12 837 institutional claim transaction. Since the data structure of the 837 transaction is difficult to express in narrative form and to provide assistance to small providers excepted from the electronic claim requirement, the instructions below are given relative to the data element names on the Form CMS-1450 hardcopy form. Each data element name is shown in bold type. Information regarding the form locator numbers that correspond to these data element names is found in chapter 25. Because claim formats serve the needs of many payers, some data elements may not be needed by a particular payer. This section provides detailed information only for items required for Medicare home health claims. Items not listed need not be completed although home health agencies may complete them when billing multiple payers. In all cases, the provider is responsible for filing a timely claim for payment. (See chapter 1.)