Home Health Telehealth Services During an Inpatient Stay

October 30, 2024

The Centers for Medicare & Medicaid Services ( CMS) has issued Change Request (CR) 13815  that revises Medicare claims editing to allow non-paid telehealth visits to be reported while a beneficiary is hospitalized.

Medicare beneficiaries cannot be inpatients in a hospital or skilled nursing facility and receive home health care simultaneously. If a home health claim is received, and the Medicare system find dates of service on the home health claim that falls within the dates of an inpatient, skilled nursing facility or swing bed claim, the home health claim will be rejected.

However, CMS will allow this date overlap when reporting telehealth services, G0320, G0321 or G0322, on the home health claim. These services are non-payable reporting items so they do not create any duplicate payment. The codes may represent the home health agency remaining in contact with caregivers while the beneficiary is an inpatient. Prior to this CR release, these codes were causing claim rejections when submitted while a beneficiary was in an inpatient facility.