Clarification: Home Health ‘Per Visit Allowance’

June 29, 2016

Regarding home health services, each “per visit allowance” is measured in unitsof 15-minute increments. Four units equal one hour of service, which equates to one “per visit allowance.” A maximum of four units may be billed as a “per visit allowance.” Each “per visit allowance” billed represents a minimum of one hour of service to the recipient, with the exception of “Home Health Aide Services,” which represents a minimum of two hours of service to the recipient. Providers may also bill and be reimbursed for a visit that does not represent the full one or two hours.(for example, three units = 45 minutes)

This clarification will be reflected in the provider manual in a future Medi-Cal Update.