HCPCS Code G0180: Physician Certification for Medicare-Covered Home Health Services

Use G0180 when the patient hasn’t received Medicare home health services in the last 60 days, and a physician certification is required to start a new episode.

No. They are mutually exclusive, representing distinct scenarios (initial certification vs. recertification following continued services).

Providers must include a signed and dated certification (e.g., CMS-485 or its successor form), confirmation that the patient has not received Medicare-covered home health services in the past 60 days, the clinical justification for home health care, review of the OASIS assessment, and evidence of communication with the home health agency.