Mich. Admin. Code 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.

Notes

Mich. Admin. Code R. 418.10909
2002 AACS; 2008 AACS; 2017 AACS; 2018 MR 5, Eff. 3/15/2018

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