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CMS Revises Editing of Home Health Telehealth Claims

Home health providers should note that from Jan. 1st to Feb. 6, 2023, the Centers for Medicare and Medicaid Services (CMS) incorrectly returned claims with telehealth services if they did not include an in-person visit with the same revenue code (reason code 31869). If CMS returned a claim from your agency, they are asking you to resubmit to your Medicare Administrative Contractor (MAC). With the Calendar Year (CY) 2023 Final Home Health Rule, CMS has put in place G-Codes for telehealth services regardless of whether they were rendered at the same time as in-person services. While providers are not reimbursed for telehealth services, CMS is collecting data to determine potential future policies around home health and telehealth.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871