Community Emergency Medical Technician (CEMT) Services

Overview

Community Emergency Medical Technician (CEMT) is a provider type used to meet the health care needs of members within the first 24 to 48 hours of being discharged from a hospital or nursing home or for safe home checks due to multiple calls for assistance at their home.

Eligible Providers

Emergency medical technicians who meet the following criteria:

1. Are currently certified as an emergency medical technician (EMT) or advanced emergency medical technician (AEMT)
2. Have two years of service as an EMT or AEMT
3. Successfully complete an education program that includes education in providing culturally appropriate care
4. Complete an Emergency Medical Services Regulatory Board (EMSRB) application form
5. Are enrolled with the Minnesota Department of Human Services (DHS)

Eligible Recipients

Members who meet the following criteria:

1. Recently been discharged from an inpatient stay in a hospital
2. Recently been discharged from a nursing home
3. Made repeated calls for assistance at their homes

Covered Services

Post-Discharge Visit

The member’s primary care provider orders the post-discharge visit. The visit must be documented in the member’s care plan.

Post-discharge visits include the following components:

1. Verbal or visual reminders of discharge orders
2. Recording and reporting of vital signs to the member’s primary care provider
3. Medication access confirmation
4. Food access confirmation
5. Identification of home hazards

Safe Home Evaluation Visit

The member’s primary care provider coordinates and is responsible for ordering the CEMT services. The order must be documented in the member’s care plan.

Circumstances that may trigger a safe home evaluation visit include the following:

1. Repeat ambulance calls due to falls
2. Individuals identified by primary care provider as at risk for nursing home placement

Safe home evaluation visits include the following components:

1. Medication access confirmation
2. Food access confirmation
3. Identification of home hazards

Non-Covered Services

1. Travel time
2. Mileage
3. Services related to hospital-acquired conditions or treatments

Billing

The PrimeWest Health-enrolled medical director of the service that employs the CEMTs bills the CEMT services.

1. Bill using the 837P
2. Code T1016 with modifier U4 for a post-discharge visit, max units = four
3. Code T1016 with modifier U5 for a safe home visit, max units = four
4. In 15-minute increments (one unit = 15 minutes)
   1. Eight minutes of a unit must be used in order to bill the unit.

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Updated_04/27/2020