Yes, you will need to change TOS, and typically most will have Medicare so the provider wants to make sure to keep good documentation because there has to be a prognosis/treatment plan for Medicare to cover it in nursing home. Diagnosis codes such as Dementia for example cause red flag to Medicare since Dementia is not treatable. If it's a psychiatrist you also want to make sure if the provider is doing med check ONLY (no psychotherapy) they will need to use HCPCS M0064 as Medicare will red flag overuse of 90862 for Medicare patients in nursing homes. If billing other carriers you will still need to get authorization and supply treatment reports when needed. There's a lot of scrutiny with mental health treatment in Nursing Homes because of a lot of fraud and abuse, so just be careful. The providers I have that go to nursing homes generally don't do psychotherapy, usually they are quickie med checks or eval's.
