Helpful Educational Tip: Medicaid Providers Performing Home Health Services for Multiple Recipients at One Location

The Agency for Health Care Administration announced for home care providers the following tip related to billing for multiple Medicaid recipients at one location.

Please remember to follow the Home Health Services Fee Schedule when billing services for multiple recipients at one location. Providers should bill using the TT modifier in all cases, and should reduce their billing for each additional recipient as indicated in the Florida Medicaid Home Health Services Coverage and Limitations Handbook for subsequent cases at the same location.

The fee schedule describes the codes associated with the type of service, the modifier, a brief description of the service, and the maximum fee that Medicaid will reimburse for the procedure as follows:

Procedure
Code
Modifier Description of Service Maximum Fee
T1021 TT Home Health Aide (HHA) Visit unassociated with skilled nursing services provided to more than one recipient in the same setting.

$17.46/per visit – 1st recipient

$8.73/per visit for each additional recipient

T1031 TT Licensed Practical Nurse (LPN) Visit provided to more than one recipient in the same setting.

$26.19/per visit – 1st recipient

$13.10/per visit for each additional recipient

T1030 TT Registered Nurse (RN) Visit provided to more than one recipient in the same setting.

$31.04/per visit – 1st recipient

$15.52/per visit for each additional recipient

S9123 TT Private duty nursing rendered by a RN (2 to 24 hours per day) provided to more than one recipient in the same setting. $29.10/hr – 1st recipient

$14.55/hr – 2nd recipient

$7.28/hr – each additional recipient

S9124 TT Private duty nursing rendered by a LPN (2 to 24 hours per day) provided to more than one recipient in the same setting. $23.28/hr – 1st recipient

$11.64/hr. – 2nd recipient

$5.82/hr. – each additional recipient

What is a TT modifier?

A TT modifier is a Health Care Common Procedure Coding System (HCPS) modifier that modifies the price of the procedure code and describes an individualized service provided to more than one patient in the same location. Modifiers more fully describe the procedure performed so that accurate payment may be determined.

If you have additional questions about billing instructions, please contact your local Medicaid area office.

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