I'm an Internist and make house-calls for my invalid patients. It generally takes me a total of 40 min of travel; I spend approximately 1h 15m with family/patient (beridden CVA), review all interval VNA documents, write necessary rx's, review all written-out changes for family (they're really over-whelmed and need written instructions) and I will email the visiting nurse with made changes. I'm billing a CPT: 99350 ($140)for the call; and a monthly CPT: G0180(CPO ($40). With monthly visits, I essentially keep this GT feed, CHF, Malignant HTN, out of the hospital. Total time for visit will equal about 2hrs (night freeway driving) and total reimbursement received on this (Medi-Medi) patient will be $112.00 (20% Medical is a write-off), then subtract gas cost and your payment adds up to a robust $100 for saving Medicare thousands at the hospital level.
After 6 monthly visits to date, I cannot keep my home service up unless there are Prolonged Codes I can add on to the existing E/M codes. Please advise me of further CPT codes I can submit to Medicare to justify my efforts. I only want to be made aware of additional/addendum codes which Medicare recognizes and pays. IE. can I use an equivalent 99354 and/or 99355 for a housecall meeting time\high severity criteria? Thanks for any anticipated imput.
Regarding the CPO monthly payments of $32.00 or $8/week (20% MediCal write-off), if I have to spend at least an hour a month authorizing VNA orders, is there also a "Prolonged CPO" kind of code which I can post monthly in order to actually loose dollars on each call? This is a really fiscal area within my practice which will either dictate continued cost-saving services for Medicare, or reflex serial in-patient admissions, whenever the visiting nurse and/or family feels that Dad looks worse each day and then call an ambulance