The recertification code, G0179, must be used when patients have received covered home health services for at least 60 days, and when the physician signs the certification after the initial certification. As a precaution, keep a copy of the approved care plan in the record. Medicare does not require physicians to submit medical record documentation with the claim for these services. You should, however, be able to provide the supporting documentation if requested. These payment rates represent the national average.
Payments vary slightly by geographic area.
Medicare previously did not provide separate reimbursement for certifying or recertifying a patient s care plan. Because these services were included in the 2001 Medicare physician fee schedule, physicians can be paid for services that they could not bill separately in the past. HCFA allowed physicians to count time spent on certification or recertification before it initiated separate payment for these activities on January 1, 2001. Brett Baker is a third-party payment specialist in the College s Washington Office. All rights reserved.