Site of Service Codes

• Required to be billed with first billable service on final episode claim 

• If location changes during the episode, new site of service code billed with first visit in new location • Revenue line with site of service Q-code should use the same revenue code and date of service as the first billable service, one unit, and a nominal charge (e.g., a penny)

HCPCs Code : Q5001

Definition : Hospice or Home Health Care Provided in Patient's Home/Residence

HCPCs Code : Q5002

Definition : Hospice Or Home Health Care Provided In Assisted Living Facility

HCPCs Code : Q5009

Definition : Hospice Or Home Health Care Provided In Place Not Otherwise Specified (NOS)

Required Fields: HH Claim Page 3

Field:  PAYER

Description/Notes : Payer Identification – If Medicare is the primary payer, enter “Medicare” on line A.

Field:  RI

Description/Notes :  Release of Information – Entering “Y”, “R” or ‘’N” 

“Y” – Indicates the HHA has a signed statement on file permitting it to release data to other organizations in order to adjudicate claims 

“R” – Indicates the release is limited or restricted

“N” – Indicates no release is on file

Field:  DIAGNOSIS CODES

Description/Notes : Enter the appropriate ICD-9-CM code for the principal diagnosis code and any other diagnosis codes for conditions that coexisted when the plan of care was established.

Field:  ATT PHYS

Description/Notes : Attending Physician – Enter the NPI and name (last name, first name, middle initial) of the attending physician that established the plan of care with verbal orders – this must be the individual physician’s NPI, not a group NPI.