Home Health

Coverage Guidelines

Please note that coverage guidelines and procedures are subject to change. Refer to the monthly Provider Updates for more information.

• Provider Participation Guidelines
• Recertification
• Reimbursement Guidelines
• Plans of Care
• Claims Billing Guidelines
• Home Health Aide Services
• Skilled Nursing Services
• Physical, Occupational and Speech Therapy Services
• Covered Services
• Home Health Aide Revenue Codes

Claim Preparation Instructions

• UB-04 Form Filing Instructions 
• Home Health– UB-04 Claim Form 

Error Status Codes

• ESC Code List (English) 

Explanation of Benefits (EOB) Codes

• EOB Codes and Messages List (English) 
• EOB Codes and Messages List (Spanish)

Appendix - Third Party Liability Carrier and Coverage Codes

• Third Party Liability (TPL) Carrier Codes 
• Third Party Liability (TPL) Coverage Codes
For specific questions you may contact the Customer Service Help Desk at (401) 784-8100 for In-state and long distance callers, or 1-800-964-6211 for In-state toll callers and border communities.