Effective December 17, 2022, DEEOIC will implement an update to procedure code Authorization and Billing for Home Health (HH) services for reimbursement using hourly and 15-minute incremented procedure codes. In addition, some per-diem Home Health procedure codes will be retired.
Key impacts:
- Providers will not be required to submit new or corrected authorization requests for authorizations submitted prior to 12/17/22 with retired codes
- Authorization requests submitted prior to 12/17/22 with retired per-diem codes will continue to be processed.
- Providers will be able to submit corrections to update units/amount and dates for service lines with retired procedure codes in Approved status after 12/17/22. However, providers will be unable to add new service lines to the same authorization using a retired code.
- If the approved authorization on file contains retired code(s), Providers should use the code(s) when billing. For example, if an authorization is approved on 12/16/22 for 6 months of per-diem home health services, then the provider should continue to use the per-diem codes for billing through the end of the approved date span.
- Providers will receive an RTP reason stating that the “Requested Procedure Code is expired or invalid” if a Home Health authorization request with retired codes is received after 12/17/22.
Please refer to DEEOIC Bulletin No.23-03 for more details.
For additional information, you may contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.
- Division of Energy Employees' Occupational Illness Compensation (DEEOIC) 1-866-272-2682