This page provides information about home health care for Blue Cross commercial and Medicare Plus BlueSM members.
See the BCN Home Health Care page for information specific to Blue Care Network commercial and BCN AdvantageSM members.
Blue Cross commercial
Blue Cross commercial doesn't require authorization for home health care. For information about home health care for Blue Cross commercial members, see the Home health care chapter of the Blue Cross PPO Provider Manual.
To access chapters of the Blue Cross PPO Provider Manual, log in as a provider at bcbsm.com, click the BCBSM Provider Publications and Resources link and then click Provider Manual.
Medicare Plus Blue
- For episodes of care that start and end prior to June 1, 2021: Medicare Plus Blue doesn't require authorization for home health care services.
- For episodes of care that start prior to June 1, 2021, and extend through or beyond June 1, 2021: Providers must request authorization through CareCentrix® in the following situations:
- Recertification is needed
- Resumption of care is needed
- Significant change in condition occurs
- For episodes of care that start on or after June 1, 2021: Providers must request prior authorization through CareCentrix.
For more information about the CareCentrix home health care program, see the resources below.
Resources and forms for the CareCentrix program
- Home health care: Frequently asked questions for providers (PDF)
- Medicare Plus Blue home health care claims: Frequently asked questions for providers (PDF)
- Home health care: Quick reference guide (PDF)
- Home health care: Clinical documentation requirements (PDF)
- Home health care: Submitting authorization requests to CareCentrix (PDF)
- Home health care: Linking your agency's NPI(s) and TIN(s) (PDF)
- Home-based services: For chronic condition monitoring and surgical decision support and for authorization determinations (PDF)
- CareCentrix HomeBridge® Portal Auth Request Guide*
From our dedicated provider training site,* you can access the webinar recording and a PDF of the webinar presentation.
To find the CareCentrix training, search on “home health care” and then click the Courses tab.
To request access to the provider training site:
- Click here to register.*
- Complete the registration. We recommend using the same email you use to communicate with Blue Cross for provider-related needs. This will become your login ID.
- Follow the link to log in.*
If you need assistance creating your login ID or navigating the site, email ProviderTraining@bcbsm.com.
*Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website. While we recommend this site, we're not responsible for its content.