Incorrect Provider Types Billing Care Plan Oversight Services for Patients Receiving Care
CPO is physician supervision of patients under the home health or hospice benefit where the patient requires complex or multi-disciplinary care requiring ongoing physician involvement. Medicare does not pay for CPO services for nursing facility or skilled nursing facility patients.
National Government Service has noticed an increase in claim denials for procedure codes G0179 and G0181 where the rendering provider is a NPP. NPPs include nurse practitioners, clinical nurse specialists, speech language pathologists, physician assistants and certified nurse midwives.
G0179 and G0181 equal the physician certification and recertification of the plan of care and these can only billed with the physician’s NPI as the rendering provider.
| HCPCS Code | HH patient |
|---|---|
| G0180 | Physician certification of HH patient |
| G0181 | Physician supervision Home Health |
| G0182 | Physician supervision Hospice |
Related Content
- CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 30, Sub Section G
- CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 180
Posted 3/19/2020