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42.7.5 Billing Units Based on an Hour
All claims for reimbursement are based on the actual amount of billable time associated with the SHARS service. For those services for which the unit of service is an hour (1 unit = 60 minutes = one hour), partial units should be billed in tenths of an hour and rounded up or down to the nearest six-minute increment.
Reminder: Enter the number of billing units in Block 24G of the CMS-1500 paper claim form. Claims without this information will be reimbursed as a unit of 1.
To calculate billing units, count the total number of billable minutes for the calendar day for the SHARS student and divide by 60 to convert to billable units of service. If the total billable minutes are not divisible by 60, the minutes are converted to partial units of service as follows:
• 0 mins-3 mins = 0 units.
•4 mins-9 mins = 0.1 unit.
•10 mins-15 mins = 0.2 unit.
•16 mins-21 mins = 0.3 unit.
•22 mins-27 mins = 0.4 unit.
•28 mins-33 mins = 0.5 unit.
•34 mins-39 mins = 0.6 unit.
•40 mins-45 mins = 0.7 unit.
•46 mins-51 mins = 0.8 unit.
•52 mins-57 mins = 0.9 unit.
Other examples:
•58 mins-63 mins = 1 unit.
•64 mins-69 mins = 1.1 units.
•70 mins-75 mins = 1.2 units.
•76 mins-81 mins = 1.3 units.
•82 mins-87 mins = 1.4 units.
•88 mins-93 mins = 1.5 units.
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