Care Plan Oversight Reimbursement...

If you spend 30 minutes per month on the care plan oversight
(CPO) of your Medicare patients on home health or hospice
services, you can bill Medicare for the time. 

Ten Criteria for Billing For Care Plan Oversight Services

• Patient must receive home health or hospice services
  that are covered by Medicare and require complex or
  multi-disciplinary care modalities requiring ongoing
  physician involvement in their plan of care during the
  period for which CPO is billed.
• The physician must devote a minimum of 30 minutes of
  his/her time per month to supervision of the patient's therapy.
• The physician who bills CPO must be the same physician
  who signed the home health or hospice plan of care and
  must personally furnish the services.
• Only one physician per patient may bill for services
  furnished during a calendar month.
• The physician must have furnished a service requiring a
  face-to-face encounter with the patient at least once
  during the 6-month period before the month for which CPO payment is first billed.
• The physician may not have a significant financial or
  contractual relationship with the Home Health Agency.
• The physician may not be the medical director of employee of the hospice and may not furnish services under the arrangement with the hospice.
• The physician may not bill for CPO if he is billing for
  Medicare ESRD capitation payment for the same beneficiary during the same month.
• To bill separately for CPO services provided during a post-operative period, the physician must document in the patient's medical record that the CPO services are unrelated to the surgery.
• Physician must include the Home Health Agency or Hospice Medicare provider number on the claim for CPO services. 

Call North Penn VNA at 215-855-8296 for our Medicare provider numbers.

Physicians are also able to bill for services involved in certifying and recertifying home health plans of care. 

Physicians should file form CMS-1500 to claim for CPO services.

Codes for care plan oversight are:
GO181 for home health
GO182 for hospice
GO180 for certification of home health plans
GO179 for recertification of home health plans

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