P2P Call Guide

How to Win a P2P Call for Home Health Services Denied by MA Plans

Payer-specific strategy, medical necessity arguments, and the exact phrases to use when Medicare Advantage denies Home Health Services (CPT 99345, 99350, G0299).

Why MA Plans Denies Home Health Services

Patient is not homebound

Skilled need not documented

Services exceed reasonable frequency

Know Medicare Advantage's Criteria

Medicare Advantage plans must cover all services covered by Original Medicare (CMS NCDs and LCDs) but may require prior auth. Plans use various criteria including InterQual, MCG, and proprietary guidelines.

Key policies to know:

  • Must cover all services covered by Original Medicare
  • Can require prior authorization not required by Original Medicare
  • CMS NCDs and LCDs serve as coverage floor
  • Organization determinations must be issued within 14 days (72 hours for expedited)

Building Your Medical Necessity Argument

Document homebound status with specific functional limitations

Define the skilled need (wound care, medication management, PT/OT)

Note why outpatient services are not feasible

Reference recent hospitalization or change in condition

P2P Call Tips for MA Plans

Cite the relevant CMS NCD or LCD -- MA plans cannot deny what Medicare covers

If the service has a CMS NCD, that trumps the MA plan's internal criteria

Reference CMS regulations on MA coverage obligations

Request expedited determination if clinical urgency exists

Guidelines to Reference

  • CMS Home Health Coverage Requirements
  • Medicare Benefit Policy Manual Ch. 7

Relevant CPT Codes

CPT 99345CPT 99350CPT G0299

Specialty: Internal Medicine / Family Medicine

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