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11 Thoughts to “Medicare reimbursement for hyperbaric oxygen therapy”

  1. Sarah

    If a patient is currently under Home Care services and now HBOT is being added, is the HBOT part of the home care payment?

  2. HBOT services must be provided under direct supervision of a physician and therefor do not fall under Home Health consolidated billing. However therapy services do. So any wound care done by the institution in conjunction with the HBOT services that are provided by therapists and billed with therapy revenue codes will not be paid separate.

    On a separate note, remember that commercial payers as well as Medicaid may not recognize the C1300 code and may require the facility to report the 99183 or their own unique procedure code with a quantity of one not four. I continue to be amazed at the missed opportunities that I find when I audit outpatient billing!

    1. SANDI

      Are you saying the wound care should be billed separately?

      Could a modifier be use?

  3. sharon rivenbark

    Under Noridian (MAC/LCD), State of Idaho, can a nurse practitioner or a physician assistant supervise HBO if they are WC/HBO certified? thank you

    1. Carrie Carls

      By definition CPT 99183 (Hyperbaric Oxygen Therapy) = “Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session”.

      The National Government Services LCD we follow in our practice area includes the following:
      “Podiatric physicians may supervise hyperbaric oxygen therapy if such a service is within their State scope of practice. However, such supervision is only covered for Medicare reimbursement when the body area or condition being treated by the hyperbaric oxygen is also within the scope of practice (e.g., a diabetic wound of the foot).

      Qualified non-physician practitioners (NPPs) may supervise hyperbaric oxygen therapy services, if such service is included within their State scope of practice, if their required supervision or collaborative agreement is with a physician qualified to provide HBOT services, and if the NPP meets the educational requirements identified herein.

      Physicians supervising hyperbaric oxygen therapy should be certified in Undersea and Hyperbaric Medicine by the American Board of Emergency Medicine (ABEM) or the American Board of Preventive Medicine (ABPM) or the American Osteopathic Conjoint Committee of Undersea and Hyperbaric Medicine (AOCUHM); or must have completed a minimum 40-hour in-person training experience in a program such as one approved by the American College of Hyperbaric Medicine or the Underseas and Hyperbaric Medical Society. Training and/or certification for providers performing HBO therapy in Jurisdiction 13 (Connecticut and New York Part A and Part B providers) and Illinois and Wisconsin Part A providers was effective on November 1, 2011. For Illinois (Part B providers), Maine, Massachusetts, Minnesota, New Hampshire, Rhode Island, Vermont and Wisconsin (Part B providers), the requirement will be effective on January 1, 2015.”

      We recommend that you check with Noridian directly to clarify their supervision requirements in your practice area.

  4. sandra lacy

    As a person that has sustained a traumatic brain injury I am curious if Medicare eill reimburse for HBOT for the treatment of cognitive deficits with the TBI. It is established that HBOT s an effective treatment for TBI cognitive deficits and also for stroke deficits.

  5. Why can a NP go through HBO training and certification but we are not reimbursed for Supervision?

  6. Laura

    I am the daughter of a Medicare beneficiary with a non-healing wound, over 60 days care at this time with several minor office debridements and is now 1 day post op deep debridement out-patient (not sure what the surgeon coded). I have coded general surgery claims about 8 years ago and, in general, am familiar with medical coding. My father (the patient) is concerned with coverage for wound care, especially if HBOT is recommended. I am not familiar with HBOT nor wound care coding at all. Can you direct me to the cms.gov articles that govern such, including those for the Local Policies of the Texas Medicare carrier? The link that was provided on the above article “errored” on cms.gov and I could not find the article from your link. I did find a 2006 policy on another web link but wasn’t certain if that HBOT policy was current or has CMS updated the policy in the past 8 years. It seems odd that that was the most recent policy I could find. Isn’t HBOT becoming more acceptible and covered? The limits and covered diagnoses seemed clear however on the 2006 article if that is still current.

    1. Carrie Carls

      Laura:

      Here is a link to the Texas LCD for HBOT.
      http://www.novitas-solutions.com/LCDSearchResults/faces/spaces/search/page
      /lcd.jspx?Jurisdiction=JH&_afrLoop=436665463598000&State=Texas&_afrWindowM
      ode=0&lcdID=L32739&medicareType=Part+B&_adf.ctrl-state=jakrrzhae_4

      And here is the link for the Wound Care LCD in Texas:
      http://www.novitas-solutions.com/LCDSearchResults/faces/spaces/search/page
      /lcd.jspx?Jurisdiction=JH&medicareType=Part+B&_afrWindowMode=0&lcdID=L3268
      7&_afrLoop=436777559793000&State=Texas&_adf.ctrl-state=jakrrzhae_13

      I hope you find these helpful! I believe the links didn’t work for the
      NGS articles because they have been updated since the article was written
      last year. NGS is the FI in our area, so it wouldn’t be helpful to you
      in Texas.

      Thank you,
      Carrie

  7. Sandra Hartwig

    What is a typical reimbursement for a hyperbaric oxygen treatment from medicare?

  8. JENNIE TURPENING

    ok. The Physician goes to the hospital and does wound care and HBOT. How would the physician’s billers bill his services? Because the hospital uses 99183 with g0277 and they are saying we bill it the same but with a modifier 25.. please help.

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