Home Health Aide

August 10, 2018: Attention Home Health Providers: Services are covered only when ordered by the attending physician and performed in conjunction with direct ongoing skilled nursing care and/or PT.
When submitting claims and reporting aide services along with skilled nursing care or physical therapy, it’s recommended to report the services in the following sequential order to allow for proper processing. The nursing and/or PT HCPCS code on the first claim line, followed by the Aide HCPCS codes. 
CHAMPS logic looks for a PAID nursing or physical therapy HCPCS service line during the same calendar month. Therefore when billing both services on the same claim, aide services could be denied if the service line is billed out of order.