Service Code Maximum Billing Per Day
Some states require that certain Home Health Service Codes specify the maximum number of hours that can be billed on a single day for that service for a single Member.
In such cases, the maximum number of allowed hours is set by Service Code, with rules specifying maximums of 12, 16, and 18 hours. When the maximum is reached, more hours for that visit or additional visits using that service code for that Member that day cannot be billed.
Maximum Billing Hours Per Day (Max Billing Hours) is only displayed for a Home Health Service Code in the Payer Portal when the Provider is set up to use the Maximum Hours Prebilling Rule. Contact HHAeXchange Support for assistance with this Provider application setting.
An authorized user can set Max Billing Hours for a Home Health Service Code on the Add Service Code or Edit Service Code page under Admin > Reference Table Management > Service Code > Add Service Code/Edit Service Code.
The Maximum Hours (Max Billing Hours) is shown for the Service Code in Reference Table Management under Admin > Reference Table Management > Service Code.
