Wiki House Call Billing

[sandravaldez]

I work for a FQHC Family Practice clinic. We would like to incorporate a day of House Calls for pts. that cannot come into the clinic due to transportation issues. (We live in a very rural area). As these visits do not meet Medical Necessity, is it ok to bill these visits with a regular E&M code instead of the Home Visit codes? Also as these visits would fall under our "clinic visit umbrella" could we bill under POS 11 instead of 12, or would this cross the line into fraudulent billing? Thanks!

 

[mitchellde]

Yes this crosses the line in a huge way. Transportation difficulties do not meet medical necessity for home visit. Unfortunate but very true. We use to have the ambulance go pick these patients up but then we had to write off the ambulance cost. there is no way around this since it is based on medical necessity.