Which provider can bill Daily care, ANCILLARY PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH PATHOLOGY

DAILY CARE

The following providers may bill for daily care and must enter the appropriate revenue code that identifies the specific daily care accommodation being billed:

* Nursing Home Facilities

* County Medical Care Facilities

* Hospital Long Term Care Units

* Hospital Swing Beds

* Ventilator Dependent Units

The NUBC Manual provides the revenue codes to be used for Michigan Medicaid.



ANCILLARY PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH PATHOLOGY

The following providers may bill physical/occupational therapy and speech pathology:

* Nursing Home Facilities

* County Medical Care Facilities

* Hospital Long Term Care Units

* Outpatient County Medical Care Facilities

When billing on the NUBC claim form, facilities must use the revenue codes and HCPCS codes identified on the MDHHS Therapy Services Database available on the MDHHS website. (Refer to the Directory Appendix for website information.)

* Each ancillary service must be billed on a separate claim line. Series billing is not allowed.

* Each claim line requires a:

* Date of service

* Revenue code and a HCPCS code

* PA number on the claim

Dual-use therapy codes may be billed by a physical therapist and an occupational therapist on the same date of service when both professionals provide covered therapy services on the same day under their corresponding treatment plans. The codes are identified on the MDHHS Therapy Services Database with required modifiers GO and GP. The appropriate modifier must always be used on the claim line to avoid a claim rejection when billing a dual-use code.

* Occupational therapy modifier: GO

* Physical therapy modifier: GP


OUTPATIENT COUNTY MEDICAL CARE FACILITIES

* When billing for therapies, outpatient county medical care facilities must indicate the Type of Bill as 23X.

* Each service must be billed on a separate claim line. Series billing is not allowed.

* Each claim line requires a revenue code and a CPT/HCPCS code.

* Each claim requires a PA number to be reported in the appropriate form locator or electronic segment.