Certified Home Health Agencies Episodic Payment System

Billing Update Regarding Service Lines - September 25, 2012

Providers should be aware that the Revenue Codes used for reporting CHHA services on episodic claims are subject to the same limitations (units billed per day) as the corresponding Rate Codes that were utilized for pre-episodic billing.

The daily limits for the 10 Revenue Codes which were previously listed in the "Billing Guidelines" for episodic billing are as follows:

Description Max. Units
Per Day
0551 Nursing - Visit 3
0421 Physical Therapy - Visit 3
0441 Speech Pathology - Visit 3
0431 Occupational Therapy - Visit 3
0572 Home Health Aide - Hour 24
0579 Shared Aide - Quarter Hour 96
0559 AIDS Nursing - Visit 3
0780 Telehealth Services - Day 1
0590 Telehealth - Installation 1
0581 MOMS Health Supportive Services - Visit 1

Computer Sciences Corp., administrator of the eMedNY billing system, is in the process of implementing new claim edits which will result in the denial of claims when reported units exceed the limits shown above.

Also, please note the following:

  • CHHAs should utilize Revenue Codes 0572 or 0579 to report Home Health Aide services for episodic claims. Revenue Code 0571 should not be used.
  • Each date of service requires a separate line on the claim. Providers should not combine hours, visits, or other units from multiple dates on a single line.

Questions regarding these instructions may be submitted to the following address: bltcr-ch@health.state.ny.us