DOH Posts Billing Guidance for COVID-19 Testing by Home Care 

Guidance initiated by HCA COVID-19 In-Home Specimen Collection Initiative  

Situation Report | November 2, 2020

The state Department of Health has developed and posted home health agency guidance for direct Medicaid billing and reimbursement for COVID-19 in-home specimen collection.

The guidance was developed in response to HCA’s statewide home care and hospice clinician training for COVID-19, supported by a grant from the Mother Cabrini Health Foundation.  

The guidance provides Medicaid rates and billing codes that agencies may use to bill directly for COVID-19 specimen collection and transportation, explaining the types of home health visits that will qualify for direct reimbursement. (Refer to pages 3 and 4 of the guidance document for qualifying detail.)

According to the guidance, qualifying visits are those made exclusively for specimen collections for the homebound, and when the collection is the only service being provided. These include active Certified Home Health Agency (CHHA) cases, non-CHHA patients who require an in-home visit for specimen collection, and Managed Long Term Care (MLTC) cases. HCA intends to clarify with DOH the document’s use of the term “homebound” in the Medicaid context (distinct from “homebound” in the Medicare context), and the document’s reference to the specimen collection as the only service being provided (presumably it means the only nursing service provided during this type of separately billable visit).

LHCSA Billing 

As with any nursing service provided under a CHHA, LHCSAs who contract to provide nursing care and specimen collection visits would be eligible for reimbursement under the CHHA’s billing and subcontract terms. This should similarly apply to CHHA, non-CHHA and MLTC cases where the LHCSA and CHHA are contracted. 

DOH Letters pending 

DOH is now in the process of posting rates and codes for each CHHA. Officials have advised HCA that these letters will be immediately sent directly to each CHHA with the requisite rates and billing codes. DOH asks that providers hold on billing until the letters are received confirming the posting of the provider’s rates and codes. 

Enroll in HCA COVID-19 Test Training  

Over 2,000 home care and hospice clinicians have enrolled in the HCA training for COVID-19 specimen collection. Tuition costs are being fully funded under the Mother Cabrini Health Foundation grant to HCA. Agencies are urged to enroll all eligible clinicians here. Please contact HCA with any questions.