10/10/2023

Correct Codes Used to Bill for Intellectual Disability Facilities

Regarding home visits. Medicare changed codes to merge rest home and home visit in 2023. I visit rest home mentally challenged and psychologically challenged facilities and billing is based upon facility? so is it ok to use new code 99347 or 99348 instead of old code 99334 or 99335? Thank you

That would be correct- if rest home visit E&M codes were used in the past, it would be appropriate to use the home visit E&M codes. Those are the correct E&M codes for patients in an intermediate facility for those with intellectual disabilities. No other information would change, such as the POS , when billing these encounters. Documentation should support the level of service billed for the updated E&M code.