Avoiding billing for overlapping services

Can you bill for more than one service per individual per day?

• Do you provide more than one service to any individuals per day?
• If so, do the services overlap?
• Is that allowed per the applicable service rule?

Here is an example. Rule NMT (5123-9-18) states:

“Providers shall not bill for Adult Day Services (ADS) during the same time period Non-Medical Transportation–Per Trip (NMT) is billed.

If you are providing both ADS and NMT, you can check your documentation to be sure your service delivery times do not overlap.

However, if you are only providing one of the services, you need to ensure your NMT services are documented exactly when individuals are dropped off at the provider facility and exactly when they are picked up and the same for documenting ADS start and end times so your times aren’t overlapping with the other provider’s times.