CMS Clarifies Effective Date for New G-Codes
The Centers for Medicare & Medicaid Services (CMS) has clarified that the effective date for the G-Codes to differentiate Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) on home health and hospice claims will be for dates of service on or after January 1, 2016.
On October 16, 2015, CMS issued Change Request (CR) 9369, which implements two new G-Codes on both home health and hospice claims. In the CR, CMS states that these two G-Codes will be applicable for hospice dates of services on and after January 1, 2016, and for home health episodes of care ending on or after January 1, 2016. With the institution of the new codes, the existing “G0154 -- Direct skilled nursing services of a licensed nurse (LPN or RN) in the home health or hospice setting” will be retired. CMS’ instructions that the change applies to home health episodes of care that end on 1/1/2016 has caused confusion and conflicts with the effective date for the new codes in the manual instructions.
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