Agencies
Services
Provider Notice issued 01/07/16
- G0299 – Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting
- G0300 – Direct skilled nursing of a licensed practical nurse (LPN) in the home health or hospice setting
- Nursing visits (G0154) through December 31st,
- Specified RN (G0299) visits planned through the end of the original certification period, and
- Specified LPN (G0300) visits planned through the end of the original certification period.
Healthcare Common Procedure Coding System (HCPCS) Code Changes for Home Health Nursing Services Effective January 1, 2016
To: Enrolled Home Health Agencies
Date: January 7, 2016
Re: Healthcare Common Procedure Coding System (HCPCS) Code Changes for Home Health Nursing Services Effective January 1, 2016
This notice identifies HCPCS code changes associated with home health nursing services effective with dates of service on and after January 1, 2016.
HCPCS code G0154 - Direct skilled nursing services of a licensed nurse (LPN or RN) in the home health or hospice setting will become obsolete effective January 1, 2016. It is being replaced with the following two new specifically defined codes that are effective January 1, 2016:
Prior Approvals in HFS Database with HCPCS Code G0154 that Span January 1, 2016
-HFS staff will end the approval effective December 31, 2015 and send a letter to the home health agency requesting the number of:
-Providers must return this letter with the information requested and staff will modify the original certification to identify the RN/LPN codes so that the provider can properly bill and be reimbursed. Providers must return this letter with the information requested and staff will modify the original certification to identify the RN/LPN codes so that the provider can properly bill and be reimbursed.
-Do not submit a new HFS 1409 Prior Approval Request form for those dates of service.
Providers may fax their return letters for intermittent nursing visits to the Review Fax Line at 217-558-4359. Return letters on approvals for in-home shift nursing should be faxed to
217-524-6948.
New Prior/Post Approval Requests that Include Dates of Service Before and After January 1, 2016:
Providers will need to submit any new prior/post approval requests with completed separate sections, with the first entry for G0154 (RN/LPN) for dates through December 31, 2015, and separate sections for dates of service January 1, 2016 and after to request RN (G0299) and/or LPN (G0300) services. These codes may be submitted on the same HFS 1409 Prior Approval Request form.
New Prior Approvals Beginning January 1, 2016 and After
Prior approval requests submitted for nursing services beginning January 1, 2016 and after must identify whether they are for RN (G0299) or LPN (G0300) visits.
Any questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 1-877-782-5565.
Felicia F. Norwood
Director