Home Health Billing

Physical Therapists (PT) must have a current, active license in accordance with the Colorado Physical Therapy Practice Act 

 Acute Home Health: All physical therapy services may be provided on pediatric and adult Home Health client and are billed using revenue code 420 on a per visit basis. No PAR is required. 

 Long-Term Home Health: Physical therapy is available to pediatric clients when prior authorized and deemed medically necessary. Physical therapy is reimbursed on a per visit basis using revenue code 421.

Occupational Therapists (OT) must have a current, active registration in accordance with the DORA Colorado Occupational Therapy Practice Act 

 Acute Home Health: All occupational therapy services may be provided to all Medicaid Home Health clients with a demonstrated need for speech therapy interventions. Occupational therapy services are reimbursed on per visit basis using revenue code 430. No PAR is required. 

 Long-Term Home Health: Occupational therapy is available to pediatric clients when prior authorized and deemed medically necessary. All Home Health speech therapy is reimbursed on a per visit basis using revenue code 431. 

Speech/Language Pathologists (SLP) who have a current, active certification from the American Speech-Language-Hearing Association (ASHA).  Acute Home Health: All speech therapy services may be provided to all Medicaid Home Health clients with a demonstrated need for speech therapy interventions. Speech therapy services are reimbursed on per visit basis using revenue code 440. No PAR is required.  Long-Term Home Health: Speech therapy is available to pediatric clients when prior authorized and deemed medically necessary. All Home Health speech therapy is reimbursed on a per visit basis using revenue code 441.

Telehealth Services include the installation and on-going remote monitoring of clinical data through technologic equipment in order to detect minute changes in the client’s clinical status that will allow Home Health agencies to intercede before a chronic illness exacerbates requiring emergency intervention or inpatient hospitalization.

 Acute Home Health: Agencies are reimbursed for the initial installation and education of telehealth monitoring equipment by billing revenue code 583 with the procedure code 98969. This initial charge shall only be billed once per client per agency. The agency may bill for every day they receive and review the client’s clinical information by billing revenue code 583 along with procedure code 98969 and the modifier ‘TG.’ No PAR is required prior to billing for acute telehealth services, but agencies should notify the Department or its designee when a client is enrolled in the service. 

 Long-Term Home Health: Agencies are reimbursed for the initial installation and education of telehealth monitoring equipment by billing revenue code 780 with the procedure code 98969. This initial charge shall only be billed once per client per agency. The agency may bill for every day they receive and review the client’s clinical information by billing revenue code 780 along with procedure code 98969 and the modifier ‘TG.’ No PAR is required prior to billing for acute telehealth services, but agencies should notify the Department or its designee when a client is enrolled in the service.