Posted on: 01 November 2018 By: wekantalk

Hello All, does anyone have any insight into reimbursement for in home allergen assessment testing?   Specifically for DIY kits Allergen Test Kits or those that could be adminstered by a Community Health Worker while visiting a patients home?   

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SCG_Ric


Thu, 11/01/2018 - 11:23

Risk stratification is critical to be able to show ROI.  For example, in Maryland, quoted funding per person was $1,500-$2,500.  At this investment level, payback for reduced ED visits and admissions only works for high need patients (like multiple ED visits).  

SCG_Ric


Thu, 11/01/2018 - 11:23

Thanks for the suggestion.  I haven't been able to find any specific Medicare guidelines in place regarding this.   I reached out to our local Medicare MAC to request some information but haven't heard anything back.   Has anyone had luck billing for this and would you be willing to share what ICD-10 and HCPCS/CPT Codes have been successful or an idea what the reimbursement for the testing will be?   

SCG_Ric


Thu, 11/01/2018 - 11:23

When we did a Community Needs Assessment of Asthma locally, we found another asthma peak in the over 65 population (I am one of them).  We found this peak in other locations as well.  Is there any progress on getting Medicare coverage for home interventions?  Perhaps starting through Mediare Advantage insurers who also provide Medicaid Managed care and have a program in place there?

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