Medicare Q&A

Do Your Homework Before 
You Bill For House Calls

A. There are no changes in the codes you would bill when you see a patient in his or her home (99341-99345, new patient; 99347-99350, established patient)-at least not at the national level or in CPT 2000. Some other considerations:

• Choose a level of service just as you would with other evaluation and management (E/M) codes. These too take into account such components as history, examination and medical decision-making. Also, you must document how much time you spent with the patient.
• If another doctor requests the visit, you might bill a consultation code (99241-99245). A letter from the referring doctor is the safest way to document why you’re billing these codes, and you must send a report letter back. For those reasons, H. Clif Gregory, O.D., of Barbourville, Ky., finds the home visit codes easier to use when he goes to a patient’s home. Also, he bills the code for cataract comanagement when he sees cataract patients in their homes.
• Use the correct place of service on the HCFA-1500 form. The correct place of service code is 12.
• Consider obtaining a referral from the patient’s primary care physician. Optometrist Michael Bacigalupi of Ballinger, Texas, uses a standard referral form before he makes a house call. “Medicare has never asked for that, but I don’t think it’s a bad idea to have that on file in case there are any questions,” he says.

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