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Home Health & Hospice Week

Regulations:

Check These Steps For Correct NPP Care Plan Oversight Billing

Published on Thu Aug 12, 2004

Physician practices that want to secure the reimbursement due to them for home health care plan oversight performed by non-physician practitioners must meet seven basic requirements, the Centers for Medicare & Medicaid Services says in the proposed 2005 physician fee schedule.
 
A non-physician practitioner can perform CPO without certifying a patient for home health services if the relationship with the physician who signs the plan of care meets one of the following conditions:
 
1. The physician and NPP are part of the same group practice;
 
2. When the NPP is a nurse practitioner or clinical nurse specialist, the physician signing the plan of care also has a collaborative agreement with the NPP;
 
3. When the NPP is a physician assistant, the physician signing the plan of care is also the physician who provides general supervision of PA services for the practice; or
 
4. The physician signing the plan of care provides regular ongoing care under the same plan of care as does the NPP billing for CPO.
 
And for Medicare to pay, the NPP providing the CPO:
 
5. Must have seen and examined the patient;
 
6. May not function as a consultant whose participation is limited to a single medical condition rather than multi-disciplinary coordination of care; and

7. Must integrate his or her care with that of the physician who signed the plan of care.

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