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  • 1.  RNs doing Home Visits

    Posted 09-03-2025 10:34
    Hello fellow nurse leaders,
    Our organization is exploring a new workflow for our nurses to conduct patient visits in their homes. 
    I'm hoping to learn from your experiences with similar programs. Specifically, I'd like to ask:
    • Do you have a structured workflow for nurses performing visits in the home? If so, what does that process look like, particularly regarding documentation and coordinating with the supervising provider?
    • What CPT/HCPCS codes do you typically use for these visits?
    • How do you handle the billing for these visits? Are they billed "incident-to" a physician's service, and what are the key challenges you've encountered with getting these services reimbursed by different payers (Medicare, Medicaid, and private insurers)?
    Any insights, sample workflows, or advice you can offer would be incredibly helpful as we work to develop our own program.
    Thank you in advance!


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    Tony Kostelnak
    Sr. Mgr, Nursing
    New York NY
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  • 2.  RE: RNs doing Home Visits

    Posted 09-04-2025 09:05

    In a patient-centered world, RNs would be able to practice freely wherever needed, right?

    To my knowledge, Medicare rules remain pretty restrictive and unchanged regarding reimbursing for home visits by an RN. https://www.medicare.gov/coverage/home-health-services

     https://www.ncoa.org/article/seven-things-you-should-know-about-medicares-home-health-care-benefit/ 

    There are E/M codes (99341 - 99350) that can be used for home visits but only when these are conducted by a physician or non-physician practitioner (PA, NP, CNM).

    What patient population / service is of interest in your organization? 

    Many services can be provided via Telehealth until at least September 30th which is the deadline by which Congress must act to either extend or remove COVID era flexibilities.



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    Leslie McDowell ANP-BC DNP RN
    Northwest AHEC/Wake Forest Univ Sch of Med
    Winston Salem NC
    ANP-BC DNP RN
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  • 3.  RE: RNs doing Home Visits

    Posted 09-04-2025 20:02

    Thanks, Leslie. I found the same E/M codes, too. Since we're a value-based care model, we don't have to bill for our services. Instead, we use E/M codes as a guide for how we structure our work and visits. Because fee-for-service E/M codes are so rigid, it's a challenge to find a model that gives us the flexibility we need while still following CMS guidelines.



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    Anthony Kostelnak
    Sr. Mgr, Nursing Strategy
    New York NY
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    Original Message


  • 4.  RE: RNs doing Home Visits

    Posted 09-05-2025 12:44
    My previous organization did some RN home visits and those were part of the CCM billing for patients with chronic conditions.
    Stephanie

    Stephanie G Witwer, Ph.D., RN, NEA-BC, FAAN
    Department of Nursing
    Emeritus Staff



    Original Message


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