As per preamble excerpt D. 4. 9. long-term care visits may be made to a maximum every 2 weeks, and a face-to-face encounter must be made when billing a visit fee.
- If you are specially called to see a patient in long-term care between 0800 and 2300 any day of the week, bill 00115 Specially Called Long-Term Care Visit (patient seen 0800 – 2300 hrs, any day). You must see the patient within 24 hours of the request and no other call-out charge is applicable.
- If on a proactive long-term care facility visit (00114), or after a specially called visit (00115) you determine a follow-up visit is necessary sooner than 14 days, submit 00114 for that follow up visit and include a claim note record explaining the medical necessity. Note: In this case, the 14 day clock restarts from the date of the extra visit. If you are clustering your visits around a specific 2 week cycle, for the first visit back in that cycle after the extra one it would be necessary to submit a claim note record indicating why less than 14 days has elapsed from the previous extra visit.