Here are billing guidelines for home health care services

Blue Cross Blue Shield of Michigan requires home health care services to be billed using the number of visits (rather than hours or incremental hours) as a unit of service.

Visits should be reported individually on separate lines to correctly reflect if multiple visits were performed on the same date of service. Note: Some services, such as therapy services (revenue codes 0421, 0431 and 0441), are only payable once per day. Only the required and appropriate number of visits should be billed for reimbursement for home health care services.

Private duty nursing shouldn’t be billed as a home health care visit. For accurate processing and reimbursement, it should be billed according to billing guidelines for private duty nursing.

Additional guidelines for reference:

• Initial assessment and subsequent evaluations

• To bill a home health care initial assessment, report “revenue code 0583, assessment.”
  Note: The initial home health assessment is the only service that can be billed during this visit.
• To bill subsequent evaluations, report “revenue code 0551, skilled nursing visit charge.”
•  Nutritionist services
•  To bill for nutritionist service, use “revenue code 0589, other home health visit.”
•  Phlebotomy
• Phlebotomy can’t be billed as a visit without the inclusion of other services.
•  Physical therapy/medicine, occupational therapy, speech therapy

• To receive full payment for physical therapy/medicine, occupational therapy or speech therapy performed in the home, report a home health care diagnosis and a physical therapy/medicine, occupational therapy or speech therapy diagnosis, along with the appropriate revenue code, on the claim.
• Report the home health care diagnosis code as the principal diagnosis and the PT/medicine, OT or ST diagnosis code as the secondary diagnosis.
• If you bill with a non-home health care revenue code or a nonpayable home health care revenue code, those lines will be rejected and deemed a provider liability as they’re "bundled" with other payable services.
• Bill line item dates of service. 
• The reported units for revenue codes 0421, 0431, 0441, 0551, 0561, 0571 and 0589 must only be reported as one per visit. Claims will be rejected if units aren’t billed with the payable home health care revenue codes and if there’s an invalid or missing revenue line date of service.

Claims not billed according to these guidelines will be denied or reimbursed at the rate for one visit.

None of the information included herein is intended to be legal advice and as such it remains the provider’s responsibility to ensure that all coding and documentation are done in accordance with all applicable state and federal laws and regulations.