Home Health Agency Services.

(a)

An approved home health agency shall be reimbursed in accordance with the maximum rates as shown below. However, in no case shall the service billed exceed charges made to the general public for the provision of similar services.

(b)

Each “Per Visit Allowance” billed shall represent a minimum of one hour's service provided to the patient, with the exception of “Home Health Aide Services,” which shall represent a minimum of two hours of service provided to the patient.

(c)

“Unlisted Services” (Procedure Code Z6918) are payable only upon prior authorization of the Department and shall include:

(d)

“Case Evaluation and Initial Treatment Plan” (Procedure Code Z6914) is for the purpose of evaluating and developing a patient's proposed treatment plan for approval by the patient's attending physician; and shall be billed one time only for each individual case. No service rendered prior to the development and signed approval by the attending physician of the “Case Evaluation and Initial Treatment Plan” is payable.

(e)

A “Monthly Case Evaluation--Extension of Treatment Plan” (Procedure Code Z6916) may be allowed after “Case Evaluation and Initial Treatment Plan,” provided such service is rendered no sooner than one full calendar month following the date of the attending physician's approval of the initial treatment plan, and no more frequently than monthly thereafter.

(f)

Services provided during the Early Discharge Visit (Procedure code Z6920) shall be provided to both the mother and her newborn in accordance with Section 51327(b).