New Patient Certification

What is New Patient Certification?

GO180 is physician service for the new certification of Medicare-covered home health services.

How do New Patient Certification payments work?

Physicians who refer Medicare patients to home health agencies may file a claim and receive payments from Medicare.

What are physicians paid?

The office par fee (reimbursement) for New Certification is $67.97. To receive payment, submit a signed copy of plan of care (485) along with HCFA Form 1500 .

Services covered by Medicare:

Physician collaboration in initiating patient care as a result of home health agency patient assessment (485) is covered by Medicare.

Rules for a successful claim per Medicare guidelines:

• New certifications are billable once for a home health certification period.
• GO180 can only be used for patients that have not received home health services in the last 60 days.
• HCFA Form 1500 must include the date, the GO180 charge of $67.97, and the home health agency provider number.
• A copy of the signed plan of care (485) must be submitted with the claim.
• The plan of care must be signed within thirty (30) days of the home health agency start of care date per Pennsylvania licensure regulations.

“Do Not’s” for filing your claim per Medicare guidelines:

• Do not submit a plan of care that has been signed by another physician or physician assistant.