Signing Initial and Subsequent 485s(Cert/Recert)
Since January 1, 2001, physicians are able to bill Medicare for initial certification, recertification and Care Plan Oversight of patients receiving Medicare covered home health services. The physician's work in reviewing the OASIS data and other assessment information would be included in these services.

1. Initial certification
Under billing code GO180, a physician may be paid for the initial certification. This code can be used only if the patient has not received Medicare covered home health services in the past 60 days.

2. Recertifications
Under billing code GO179, a physician may be paid for the recertifcation. This code can be used after the patient has received services for at least 60 days when the patient is recertified. While generally the GO179 code can be reported only once every 60 days, it can also be used when a patient starts a new episode before the 60 days elapses and requires a new plan of care to start a new episode. This would occur where the patient voluntarily transfers to another agency before the lapse of the episode and where the patient is discharged with goals met and readmitted during the 60-day period.

Care Plan Oversight
For services provided by physicians on behalf of home health patients between the certification and recertification periods, billing would occur under code GO181.

• Care plan oversight reimbursement requires at least 30 minutes or more of activities within a calendar month. There is a single billing available for each calendar month to reflect the aggregate activities of the physician in supervising and managing a complex and multi-disciplinary care plan.
• Included activities in the 30-minute calculation are
• Review of charts, reports, treatment plans, or lab or study results, except for the initial interpretation or review of lab or study results that were ordered during or associated with a face-to-face encounter.
• Telephone calls with other health care professionals (not employed in the same practice) involved in the care of the patient.
• Team conferences (time spent per individual patient must be documented).
• Telephone or face-to-face discussions with a pharmacist about pharmaceutical therapies.
• Medical decision making
• Activities to coordinate services are countable if the coordination activities require the skills of a physician.
• Although we cannot help you bill, we will be happy to inservice you and your staff. Please contact us to arrange for your inservice at (972)660-2401