• CMS Transmittal 8136: Place of Service and Ordering Physician Reporting


    CMS issued Change Request 8136 that requests new data reporting requirements for Home Health Prospective Payment System (HH PPS) claims.

    Set to go into effect July 1, 2013, Home Health Agencies (HHAs) must start reporting new codes indicating:

    1.  The location of where services were provided, and

    2.  Whether services were added to the HH plan of care by a physician who did not certify the plan of care.

    >>> UPDATED April 3, 2013:  CMS published an updated transmittal which effectively rescinded and replaced change request 8136.12 and removed instructions regarding reporting the new modifier for visits not ordered by the certifying physician for episodes starting on or after July 1, 2013. <<<

    The location where services were provided should be reported along with the first billable visit in a home health PPS episode with one of three Q codes:

    1.  Q5001  – Provided in a patient’s home/residence

    2.  Q5002 – Provided in an Assisted Living Facility

    3.  Q5009 – Provided in a place not otherwise specified (NO)

    Further, changes in the location during an episode must be reported on the corresponding line to the first visit in the new location.



    As part of Sansio’s Software as a Service model, HomeSolutions.NET customers will be provided with software updates prior to the effective date of this regulation. These updates will be accompanied by release notes and a webinar to help customers most effectively manage to the new requirements.  Sansio will continue to work with industry leaders to identify clarifications and will incorporate evolving details into feature design as they become available.

    View the complete CMS MLN 8136 here.