Service Codes

Go to Admin > Contract Setup >Search Contract to locate the applicable contract.
Select the applicable contract from the search results.
Select the Billing Rates tab and click the New Rate button.
On the Contract Rate window, complete the required fields to include: Discipline, Service Code, From/To Date, Rate, and Billing Units Per Hour.
Click Save.

Additional Service Code fields on the Contract Service Code window are used to address specific billing and scheduling scenarios.

Field	Description
Mutual	Select this checkbox if the Service Code is used for Mutual Visits. Overlapping visits scheduled with a Mutual Service Code may be scheduled with the same Caregiver without triggering a validation error.
Allow Patient Shift Overlap	Select this checkbox if the Service Code is used for visits that overlap. This allows two separate Caregivers to be scheduled for a single Patient at the same time without triggering a validation error.
Bypass Prebilling Validations	Select this checkbox to allow visits scheduled with the associated Service Code to bypass Prebilling validations, with the following exceptions: Incomplete Confirmation With TEMP Caregiver OT/TT Not Approved Restricted Caregiver
Bypass Billing Review Validations	Select this checkbox to allow visits scheduled with the associated Service Code to bypass all Billing Review validations.
Auto-Schedule Service Type ID	This field allows Agencies using the Service-Specific EVV Confirmation model to enter a 4-digit identifier for the Service Code. When a Caregiver enters this 4-digit identifier at Clock Out, the system applies the Service Code to the visit.
Location Code	Code based on the location (region) of the servicing Agency/Office for billing purposes.
Weekend/Holiday Codes	Select this checkbox to activate the second Weekend Holiday Code fields. Codes entered in these fields only apply to respective weekdays (with weekday code) and weekends (weekend code).
Apply the Holiday Code to Weekday	Selecting this checkbox applies Weekend/Holiday Codes on either weekends OR holidays according to the chosen Holiday Template. Authorizations selected as Weekend/Holiday in the authorizations section pulls from visits that occur on a weekend OR a weekday if the holiday happens to fall on a weekday (M-F).
Mileage Code	Select this checkbox to apply a mileage event on the Patient Calendar.
Default Mileage Code	Select this checkbox to display entry on the Patient and Caregiver Calendars allowing the default code to be billable and payable. Only two Default Mileage Codes can be enabled per Contract; apply to Other (Skilled) and Other (Non-Skilled) disciplines.
Custom Hourly Rounding	Select to apply custom hourly rounding logic to the Service Code, as follows: 0-52 minutes: EVV visit confirmation times between 0 to 52 minutes amount to 0 units; thereafter, billing units are calculated in increments of 59 minutes. 0-14 minutes: EVV visit confirmation times between 0 to 14 minutes amount to 0 units; 15 to 60 minutes are rounded up to the hour. Thereafter, 30 minutes or more are rounded up to the hour; less than 30 minutes are rounded down to the hour. Billing units are calculated accordingly. Once selected, all visits with this Service Code applied override Contract-Level Rounding Rules.
Description	Enter content to include in the Notes section of a claim file to help support/reference the claim. If left blank, then the Visit Confirmation Times are displayed on the claim.
Code Configuration
Export / Revenue / Taxonomy / HCPCS / Location Code	These codes are used in the actual Invoice file for Billing. The Export and Weekend/Holiday Code fields are created and managed in the Export Code Reference Table. Refer to the Export Code Reference Table section below.

Contract Service Code Closed

On the Contract Service Code window under Contract Setup > Search Contract >Service Code link, the Export Code fields (Weekday and Weekend/Holiday Codes) are dropdown fields to select from.

Create an Export Code Closed

To add a new value, click the Add button above the search grid. The Add Export Code window opens. Enter the Export Code in the required field. The Status field is Active by default. Click Save.

Export Codes cannot be duplicated or deleted. To deactivate an Export Code, set the Status to Inactive.

Create a Service Code Closed

Go to Admin > Reference Table Management .
Select Contract Service Code from the Reference Table field and click Search to continue.
On the Search Results page, click the Add button.
On the Contract Service Code window, select all required fields to include a Contract , Discipline, Service Code, Rate Type, and Visit Type.
Click Save to finalize.

Edit an Export Code Closed

To edit an existing Export Code, click the applicable Export Code Name link from the Export Code Reference Table. The Edit Export Code window opens. Edit the Export Code in the required field. Select Inactive to deactivate the code; otherwise, leave as Active. Click Save.

The Edit window contains a History link to view the past activity for the Export Code.

When adding a modifier to an existing Export Code, a : colon must be added after the existing code. For example, Export Code T1019 with a modifier of 95 is entered as T1019:95 in the Export Code text field.

Export Code Reference Table Closed

All Export Codes (including Weekday and Weekend Codes) are created and stored in the Export Code Reference Table. To access the table, go to Admin > Reference Table Management and select Export Code under the Fiscal category from the Reference Table field. Click the Search button to generate the table.

Inactive Export Codes Closed

If an existing Active Export Code is made Inactive, then the code displays with an (Inactive) on the dropdown, as seen in the following image. Inactive Export Codes are unavailable selections in the Contract Service Code window.