Billing and Coding: Home PT/INR Monitoring (G0249) Billing and Coding

Medicare covers home PT/INR monitoring (HCPCS G0249) for beneficiaries who meet NCD 190.11 criteria, with coverage defined as one test per calendar week and one billable unit equal to four tests. Providers may bill only after the fourth test has been completed and reported to the treating physician; partial billing is allowed with modifier -52 and pro-rating when testing discontinues, and extra home tests beyond the four-test unit are not payable under G0249 (beneficiary financial responsibility with ABN recommended).

"Medicare covers home PT/INR monitoring using HCPCS G0249 for beneficiaries who meet the coverage criteria in Medicare NCD 190."

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