Updated RN and LPN G codes for Home Health and Hospice

Providers Should Prepare for Setting Changes.

Late last week CMS posted change request (CR) 9369  to split out the G codes for RNs and LPNs. The current G code for RN and LPN is G0154. The new G codes for dates of service on or after January 1, 2016 are as follows:

  • RN – G0299 Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting
  • LPN – G0300 Direct skilled nursing of a licensed practical nurse (LPN) in the home health or hospice setting

While creation of the new G codes was spurred by the need to distinguish between RN and LPN visits for implementation of the Hospice service-intensity add-on (SIA) that goes into effect in January, it is important to note that these code changes apply to both hospice and home health.

  • Impact for Hospice:  The new G codes apply to Hospice dates of service on or after January 1, 2016. Providers should begin the process of updating their RN and LPN profiles/settings within their hospice software in advance of the January 1st SIA implementation date, as Hospice software programs will mostly like be programmed to use the new G0299 code for to calculate SIA.[gdlr_space height=”10px”]
  • Impact for Homecare: The National Association of Homecare recently alerted Providers through their list serve and a recent NAHC article that they have asked CMS for further clarification on the implementation date of the new G codes in relation to Episode dates. Once clarification is received, homecare providers will need to update their RN and LPN profiles/settings within their homecare software programs for use on claims. HEALTHCAREfirst will alert clients and providers once it is determined if the implementation date is based on Episodes that end or begin January 1, 2016 and after.

The full CR is available here.
The NAHC article can be accessed here.

October 21, 2015

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