PPS billing-reasonable amount?

Specialties Home Health

Published

Does anyone have a list of what amounts of specific supplies are considered reasonable amount to provide to patients. For example, how many catheter bags per episode or per month are to be provided by the agency? We typically order 1 night bag and 1 leg bag per month,, but some clients want new bags every week, this doesn't seem reasonable to me but I was looking for some sort of official guidelines to go by. How about dressing supplies,is a certain amount reimbursable?

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Specializes in MS Home Health.

I have a list of what your requried to provide off the Medicare website. Long. You can get it there. As far as how often or how much of items they get under PPS I think weekly catheter bags is also unreasonable. Do you have a wound formulary or contracts with a DME for good pricing?

renerian

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Specializes in ER, ICU, Nursing Education, LTC, and HHC.

Hey Ren...

Can you get me the link you are referring to in regards to supplies?

Under PPS, I agree a weekly bag is too much, since none of the supplies are reimbursable anymore. The less you use, obviously the better.. however, I make certain all the patients get what hey need regardless if it is more than what I think is reasonable compared to other clients.

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Specializes in MS Home Health.

Sorry Monica I did not see your post. I will look tonight and post some sort of link.

renerian

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