Home Health Care
Billing and Reimbursement
Policy Number: RP-P-019
Last Updated: Feb. 28, 2022
Home health services must be preauthorized.
When home health services are not preauthorized, medical records must be reviewed with the claim. Documentation must include the physician order, nursing notes and care plans. BCBSNE will request this information if it is not submitted with the claim.
Additional Billing Instructions
- Each day’s visit must be on a separate line. If more than one visit is performed on the same day, combine the hours from both visits and bill the authorized hours on the same line.
- EXCEPTION: If you elect to bill authorized and non-authorized hours, you must split the authorized and non-authorized hours on different lines.
- Travel time includes all time to and from patient’s home to your office or another patient’s home.
- Some member contracts have per-day limits on the allowed number of home health care hours.