Physician supervision of any patients under home health (or hospice) is called Care Plan Oversight (CPO).  These patients receive complex healthcare that requires a physician to be involved on an ongoing basis.  CPO is not covered for patients in a skilled nursing facility (SNF) or other nursing facilities, only hospice and home health.  

Requirements for home health include:  

• The patient is confined to their home (homebound)
• The patient is under the care of a physician
• The patient requires skilled services 
• The patient has an established home health plan of care (POC) that is regularly reviewed by a physician 
• A face-to-face encounter with a physician was no more than 90 days prior to the start of home health or occurred within 30 days after  

When a patient has been determined to need services of a home health agency (HHA), the codes available for billing the CPO are G0179 – G0182.  (Expanded explanations below)

• G0179:  Recertification of a patient for home health care
• G0180:  Certification of a patient for home health care
• G0181:  Home health care supervision (a minimum of 30 minutes per month required)
• G0182:  Hospice care supervision (a minimum of 30 minutes per month required)

The short description for G0179 is “MD recertification HHA PT” and can only be claimed once every 60 days unless the patient starts a new episode within 60 days, but this is rare.  Otherwise, it is only used once per certification period.  G0179 includes time for contact with the HHA and review of patient status reports.  

The short description for G0180 is “MD certification HHA patient.”  G0180 is used for the initial certification when the patient has not received Medicare-covered home health services for over 60 days.  It also cannot be used along with the code G0181 on the same date of service.  

The short description for G0181 is “Home Health Care Supervision.” G0181 covers the multidisciplinary care involved when reviewing patient status reports, labs, and other studies, necessary contact with other health care professionals involved in the patient care, and revision or continuation of the patient care plans for home health services.   

The short description for G0182 is “Hospice Care Supervision.”  G0182 covers the multidisciplinary care involved when reviewing patient status reports, labs, and other studies, necessary contact with other health care professionals involved in the patient care, and revision or continuation of the patient care plans for hospice.  

All codes G0179 – G0182 must be billed during the period that the patient was receiving Medicare-covered home health or hospice services.  

For more details instructions on billing for CPO, please visit the CMS website.  

Medicaid Coverage

Medicaid will not reimburse the physician for certifying the home health plan of care. This is considered as an already reimbursed through any evaluation and management services provided throughout the period of illness that the recipient is receiving home health care assistance.

Medicaid would cover Home Health services provided by the Home Health Agency but not for the physician who certifies the Home Health plan of care.