Medical Billing Forum

Billing => Billing => : rdmoore2003 November 03, 2010, 12:29:22 PM

: home visits
: rdmoore2003 November 03, 2010, 12:29:22 PM

I have noticed that home visits are starting to come back.   Does anyone know if Blue Cross is reimbursing for home visits?   

: Re: home visits
: Michele November 03, 2010, 02:46:24 PM

I think it will vary from plan to plan and state to state.  Personally I believe our local BC pays for home visits if the patient isn't able to travel to the office.

Michele

: Re: home visits
: rdmoore2003 November 03, 2010, 07:54:24 PM

ok, so for example:   if we have a bc client for therapy and is a chronic pain patient.   if covered by bc, and provider goes to the home for a therapy visit (mental health) for 45-50 minutes (90806), would i use this code and place of service as patient home?   the description of a 90806 is in office or non facility, is non facility concidered a person's home?
have I confused you yet?  I appreciate any help, and thanks michelle

: Re: home visits
: PMRNC November 04, 2010, 09:12:52 AM

You have to call the carrier to establish medical necessity and then obtain an authorization, the mental health carriers that cover home visits will review on a case-by-case basis, I believe you will have to have the referring physicians information to show why the patient cannot travel to the office.

: Re: home visits
: Michele November 04, 2010, 09:48:59 AM

But yes, if the therapy is approved, you would just use the 90806 with the place of service as 12.

: Re: home visits
: rdmoore2003 November 04, 2010, 01:45:42 PM

ok great.  thanks for your help.   This is a territory we are looking into and I just trying to cover all basis for my providers.

: Re: home visits
: PMRNC November 05, 2010, 09:32:16 AM

I have one client who does a couple of here and there home visits, one of the carriers is Aetna and the other is BCBS, both will actually authorize home visits after medical documentation is submitted from the medical provider and they will issue the authorization that will specifically state for home visits. Both only authorize one at a time though so we have to keep on top of the patient's doctor for when a new treatment report is needed.

: Re: home visits
: rlh76 December 28, 2010, 01:00:06 AM

Is there a way to get paid for travel time/mileage for home visits?  What cpt4 would be used...for example to send to a workers comp or auto carrier?

: Re: home visits
: rdmoore2003 December 28, 2010, 10:59:44 AM

that is a very good question.   I would love to find out that answer also.   However, I am thinking that drive time may be included in the cpt. 

: Re: home visits
: Michele December 28, 2010, 04:00:11 PM

I am not aware of any cpt code for travel time/mileage.  I believe it is included with the rate when the place of service 12 is used.

: Re: home visits
: PMRNC December 31, 2010, 10:14:00 PM

NO they cannot bill for travel/mileage..it is considered to be included.