Providers spend time providing patient care without actually interacting with the patient in person or, in some cases, at all. Examples of this type of care are making follow-up phone calls to the patient, reviewing lab results, and coordinating care with another provider. There are circumstances that allow for the time spent to be billed as care plan oversight (CPO). Use the Care Plan Oversight feature to document time spent performing care plan oversight as well as bill for CPO.
- From the NextGen Office EHR Dashboard, navigate to a patient's chart.
- Click the Care Plan Oversight tab.
- The page will provide the following information:
- Patient care setting
- Last encounter
- Last CPO claim
- Patient's insurance profile
- CPO log
- Select a Patient Care Setting. The setting affects the CPT codes that prepopulate on the CPO Billing page.
The following are the CPT codes that prepopulate, sorted by care setting.
- Home health:
- 99374 - 15 to 29 minutes of care plan oversight
- 99375 - 30 minutes or more
- G0181 - Medicare
- Hospice:
- 99377 - 15 to 29 minutes of care plan oversight
- 99378 - 30 minutes or more
- G0182 - Medicare
- Nursing facility:
- 99379 - 15 to 29 minutes of care plan oversight
- 99380 - 30 minutes or more
Enter a New CPO Record
- The date defaults to today's date. To edit, click the date, select a date, and then click Done.
- Select a Category, Type (if applicable), and Provider.
- Enter the number of minutes.
- Click Save.
Create a CPO Claim
The CPO Log screen displays the history of CPO claims. Filter this list by month and provider.
- On the CPO Log screen, click CPO Billing. Note: Patients with less than 30 minutes of CPO require additional oversight to qualify for CPO billing (the CPO Billing button is disabled).
- You are navigated to a different screen where you can enter the diagnosis code and service line information to submit a claim.
- Use the diagnosis coding tool to select a diagnosis code.
- Enter modifiers (if necessary) and confirm the units.
- To associate a diagnosis with the CPT code, first select the row of the procedure and then click the appropriate diagnosis button (more than one diagnosis can be associated).
- All of the available procedural codes are displayed as buttons at the bottom of the page. Click to add them as service lines.
- Click Generate PM Billing. A user hold claim is created and a message displays with the claim ID.
- To return to the Care Plan Oversight page at any time, click Return to CPO.
CPO Reports
- The CPO report identifies which patients have accumulated CPO time for the month.
- On the EHR's bottom blue bar, click Documents.
- Click My Reports and then click CPO Report.
- Use the menu options to filter by year, month, or provider.
- Click the chart number to navigate to that patient's chart.
