On December 8, 2022, the U.S. Food and Drug Administration (FDA) amended the emergency use authorizations of the updated (bivalent) Pfizer-BioNTech and Moderna COVID-19 vaccines to include use in children down to 6 months old. Your patients may know these as “updated COVID-19 vaccines”:
Starting with claims for services on January 1, 2023, the 2 E/M visit families titled “Domiciliary, Rest Home (e.g., Boarding Home), or Custodial Care Services” and “Home Services” are now 1 E/M code family. The new family is titled “Home or Residence Services.” Use the codes in this family to report E/M services you provide to a patient in:
Clinical Laboratory Improvement Amendments (CLIA) regulations require a facility to be appropriately certified for each test they do. CMS edits laboratory claims at the CLIA certificate level to make sure that Medicare and Medicaid only pay for laboratory tests in a facility with a valid, current CLIA certificate.
Data on telecommunications technology use during a 30-day period of care at the patient level isn’t currently collected on the Home Health (HH) claim. While the provision of services provided via a telecommunications system must be in the patient’s plan of care, the Centers for Medicare & Medicaid Services (CMS) doesn’t routinely review plans of care to determine the extent these services are actually provided.
Effective, January 3, 2023, CMS will add the following codes to the home health consolidated billing non-routine supply code list: