Wiki Newbie to HHA Billing-- Help.

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cincin0713

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Hi all,

I just joined a home health agency (pediatric) and would like to see if you guys can provide some pointers when it comes to billing. I'm also new to the UB-04 forms as I've always worked in a physician based setting. If providing therapy (e.g. OT, PT, ST) services, should these be billed on a UB-04 form? Or should they be on a CMS 1500 form? Also, if on a UB-04, would TOB be 32x or 34x? I'm trying to better understand the billing process and figured this would be a great place to start. Thanks!
 
Here's the guidance for Home Health Agency billing from CMSs.

Check your MAC for additional guidance.

HHA are paid via a prospective payment system, so the billing is very different from fee-for-service that pays physicians. Here's another CMS resource. https://www.cms.gov/Center/Provider-Type/Home-Health-Agency-HHA-Center

Your type of bill is going to vary. https://www.cgsmedicare.com/hhh/education/materials/pdf/home_health_billing_codes.pdf Here's a cheat sheet from the MAC, CGS. There's information on billing for therapy (on the UB). This is a pretty decent (and recent) guide.

Hope this helps. Let me know if you can't get the links and I'll email you the documents.
 
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