tci Medicare Compliance & Reimbursement - 2004 Issue 36

Physicians: NPPs Can Bill For Care Plan Oversight

Starting next year, non-physician practitioner staff can keep track of home health care plans and receive payment from Medicare.In the past, Medicare rules on NPPs billing for care plan oversight (G0181) were an unruly tangle. On the one hand, a 1997 law said NPPs could bill for home care oversight as long as they practiced within their states' laws. On the other hand, the Centers for Medicare & Medicaid Services had decreed that only the provider who certified home care services could bill for CPO.Now, CMS has clarified in the proposed physician fee schedule that NPPs can...

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