R 418.10909 Billing for home health services.

Rule 909. (1) Services provided by a home health agency are considered ancillary services requiring a written prescription by a licensed practitioner certifying medical necessity. A copy of the prescription shall be attached to the bill. (2) A home health agency shall submit charges to the workers' compensation carrier using the UB-04 claim form. (3) A home health agency shall use procedure codes from the HCPCS Level II codebook, as adopted by reference in R 418.10107 to identify services provided. (4) A home health agency shall not bill for the services of a social worker unless the certified social worker is providing medically necessary therapeutic counseling. (5) A home health agency may bill supplies with 99070, the unlisted CPT® code for miscellaneous supplies, or the appropriate supply code from the HCPCS Level II codebook as adopted by reference in R 418.10107. (6) When a procedure code is described by the HCPCS Level II codebook as per diem, the "by report" service is reimbursed per visit. When the HCPCS Level II codebook describes a service as time-based the service is "by report," and the procedure is reimbursed according to the time provided.