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Provider update: October 1, 2020

To:  ADvantage Nursing Service Providers

Subject:  Skilled/Extended State Plan Nursing Visits (G0299/G0300/TF Modifier)

Date:  October 1, 2020

To assist providers with documenting services provided outside of the Member's home for Skilled and Extended State Plan Nursing activities (filling med-planners, skilled nail care, wound care, etc.), the following update has been made to the ADv/SPPC–Nurse Evaluation document available in the Harmony Documents tab:

Please note the following:

  • Skilled Nursing Visit must be selected for the new data boxes (highlighted above) to populate.
  • The Skilled Nurse or designee must collaborate with the Case Manager regarding additional units used to ensure adequate units are available for the Member's entire Service Plan Year.
  • Units used outside of the Member's home must relate to a corresponding in-home skilled visit. Appropriate documentation of the units used outside of the Member's home is required (i.e. calls for physician orders, managing Member's prescriptions with pharmacy, arranging for wound care supplies, etc.).
  • Documentation should include the date of skilled nursing activities outside of the Member's home and the number of units used.  Please note that total time for activities completed on any given day that are less than eight (8) minutes, do not meet the threshold for billing.

Please submit any enquiries to PQ regarding this change.

Thank you. 

AGING SERVICES | MEDICAID SERVICES UNIT

ADvantage Administration | State Plan Personal Care

Office: 918-933-4900 | CareLine: 800-435-4711

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