|
24.5.6 Supplies Submitted with a Plan of Care
The cost of incidental supplies used during an SN visit or a HHA visit may be added to the charge of the visit ($10 maximum for supplies and included in C-G0154 visit code). Medical supplies left at the home for the client or a subsequent home health nurse to use must be billed with the provider identifier enrolled as a DME supplier after prior authorization has been granted by the TMHP Home Health Services Prior Authorization Department.
A home health agency provider may request prior authorization for supplies/DME by utilizing the Home Health Services POC or the Home Health Services (Title XIX) Durable Medical Equipment (DME)/Medical Supplies Physician Order Form.
The home health agency may utilize the Home Health Services POC to submit a prior authorization of supplies/DME that will be used in conjunction with the professional services provided by the agency, such as SN, PT, or OT. The home health agency's DMEH provider identifier must be submitted on the POC and all of the supplies that are requested must be listed in the supplies section of the POC. The POC does not require a physician's signature prior to submission for prior authorization of professional services/DME and supplies.
If the home health agency utilizes the Home Health Services (Title XIX) Durable Medical Equipment (DME)/Medical Supplies Physician Order Form, the agency must complete Section A. The physician must complete Section B, and sign prior to submission to TMHP for prior authorization of the requested supplies/DME.
The following information is required to consider these supplies for authorization:
• Item description.
•Procedure code.
•Quantity of each supply requested.
•MSRP for items that do not have a maximum fee assigned.
|
