Home Health Billing Cheat Sheet (2026)
Home health billing depends on documentation the physician owns: a signed certification, a timely face-to-face encounter tied to the qualifying condition, and a plan of care. Miss the timing and the episode is not payable no matter how good the care was.
Quick reference for home health billers. Last updated .
Top Home Health CPT Codes & 2026 Medicare Allowables
| Code | Description | Non-Facility | Facility | Total RVU |
|---|---|---|---|---|
| 99347 | Home visit, established patient, low MDM | $46.09 | $46.09 | 1.38 |
| 99348 | Home visit, established patient, moderate MDM | $78.83 | $78.83 | 2.36 |
| 99349 | Home visit, established patient, high MDM | $132.27 | $132.27 | 3.96 |
| 99350 | Home visit, established patient, very high MDM | $193.06 | $193.06 | 5.78 |
| 99344 | Home visit, new patient, moderate MDM | $146.63 | $146.63 | 4.39 |
| 99345 | Home visit, new patient, high MDM | $210.09 | $210.09 | 6.29 |
National 2026 Medicare Physician Fee Schedule estimates (total RVU multiplied by the conversion factor). These are adjusted by state locality. See the per-state table on the Home Health billing services page.
Modifiers That Prevent Home Health Denials
An ABN is on file for services likely to be denied as not covered, preserving patient liability.
Therapy discipline designators (occupational, physical, speech) on the plan of care where required.
A significant, separately identifiable E/M on the same day as another reported service during a home visit.
A distinct service separate from another that NCCI would otherwise bundle.
Substitute physician arrangements (reciprocal or fee-for-time) covering the visit where applicable.
Component split where a diagnostic service is performed in the home and read elsewhere.
Top Home Health Denials → Quick Fix
The physician certification of home health eligibility must be signed and dated within the required window. An unsigned or late certification makes the episode unpayable.
Document the face-to-face encounter within the required window, performed by an allowed provider, addressing the condition that supports home health eligibility.
Maintain a plan of care established and periodically reviewed by the physician. An absent or stale plan of care fails the eligibility documentation.
99347 to 99350 are leveled by MDM or time. Document the elements that support the level; defaulting all visits to one level is a coding denial.
Care plan oversight requires the documented non-face-to-face time threshold in the month. Log the time; without it the oversight code is denied.
NCCI Bundling Watch-Outs
Code pairs from this specialty's set that carry NCCI edits. Billing both without a justified modifier triggers a bundling denial.
| Code | Bundles With | Rationale |
|---|---|---|
| 99347 | 0362T | Misuse of Column Two code with Column One code |
| 99347 | 0373T | Misuse of Column Two code with Column One code |
| 99348 | 0362T | Misuse of Column Two code with Column One code |
| 99348 | 0373T | Misuse of Column Two code with Column One code |
| 99349 | 0362T | Misuse of Column Two code with Column One code |
| 99349 | 0373T | Misuse of Column Two code with Column One code |
| 99350 | 0362T | Misuse of Column Two code with Column One code |
| 99350 | 0373T | Misuse of Column Two code with Column One code |
Documentation That Holds Up on Appeal
The physician signature and date within the required window, tied to the qualifying condition.
The encounter date, the performing provider, and that it addressed the home-health-qualifying condition.
Establishment and periodic physician review within the required intervals.
MDM or total time supporting the visit level billed.
The cumulative non-face-to-face time in the calendar month supporting the oversight code.
Revenue Home Health Practices Leave on the Table
Unpayable episodes because certification or the face-to-face was late, missing, or unrelated to the qualifying condition.
Defaulting all home visits to one level instead of leveling by MDM or time.
Not billing care plan oversight when the monthly non-face-to-face time threshold was met and could have been documented.
Stale plans of care that fail the eligibility documentation for the whole episode.
Home Health Billing FAQ
What documentation makes a home health episode payable?
A signed and timely physician certification, a face-to-face encounter within the required window addressing the qualifying condition, and an established, periodically reviewed plan of care. Any one missing or mistimed makes the episode unpayable.
How are home visit levels chosen?
99347 to 99350 are leveled by medical decision-making or total time. The note has to support the chosen level; defaulting every visit to one level is a coding-accuracy denial.
When can care plan oversight be billed?
When the documented cumulative non-face-to-face physician time in the calendar month meets the threshold for the oversight code. The time has to be logged to support it.
Who can perform the face-to-face encounter?
An allowed provider within the required window, documenting the condition that supports home health eligibility. An unrelated or out-of-window encounter does not satisfy the requirement.
Stop Losing Home Health Revenue to Preventable Denials
Our AAPC-certified home health coders apply every rule on this sheet to your claims. Call 888-701-6090 for a free billing assessment.