Newly Certified Home Health Provider or Provider Number Change

For providers who are newly certified Medicare home health providers or whose provider number has changed, it is important to remember that the beneficiary's start of care (SOC) date cannot be prior to your provider number effective date. This requirement applies even if you had been providing services to the beneficiary prior to receiving your Medicare number.

The SOC date on the plan of care (POC) should reflect the date of the first Medicare billable visit. The ADMISSION date (FL12) on the UB-04, or the ADMIT DATE field on Claim page 01, should be the same as the SOC date on the POC. Cahaba encourages you to obtain a verbal order or new documentation from the physician to change the SOC date. A new OASIS assessment must also be completed, as is required any time the Medicare payment source changes.

Page last updated: August 20, 2008