2008 Case-Mix Refinement to the Home Health Prospective Payment System (HH PPS)
HH PPS Refinement Resources
Read
- Change
Request 6393
(System
editing update to ensure that changes to non-routine supply severity
levels on HH PPS claims are appropriate) - Medicare Learning Network (MLN) Matters Article MM6393
(Provider
instructions from CMS about ensuring that changes to non-routine supply
severity levels on HH PPS claims are appropriate) - Change
Request 6305
(Correction
to HH PPS episode sequence edits) - Medicare Learning Network (MLN) Matters Article MM6305
(Provider
instructions from CMS the system changes to correct HH PPS episode
sequence edits.) - Change
Request 6283
(System
change to exclude Low Utilization Payment Adjustments (LUPAs)
from HH PPS episode sequence editing) - Change
Request 6250
(Claim
adjustments by RHHIs to correct errors associated with the implementation
of HH PPS case-mix refinement) - Medicare Learning Network (MLN) Matters Article MM6250
(Provider
instructions from CMS about RHHI claim adjustments to correct errors
associated with the implementation of HH PPS case-mix refinement) - Change
Request 6027
(Written
instructions from CMS for system editing to exclude fully denied
medically reviewed episodes when determining episode timing) - Medicare Learning Network (MLN) Matters
Article MM6027
(Provider
instructions from CMS about excluding fully denied episodes by medical
review when counting adjacent episodes)
- Change
Request 5877
(Written
instructions from CMS for system editing of “add-on” amounts
applied to Low Utilization Payment Adjustments (LUPAs) on “refined” HH
PPS claims) - Medicare Learning Network
(MLN) Matters Article MM5877
(Provider
instructions from CMS about application of LUPA add-on amounts) - Change
Request 5776
(Written
instructions from CMS for system editing of non routine supplies
(NRS) on “refined” HH PPS claims) - Medicare Learning
Network (MLN) Matters Article MM5776
(Provider
instructions from CMS about NRS editing on HH PPS claims) - Change
Request 5746
(Written
instructions from CMS for submitting claims under the refined PPS
requirements) - Medicare Learning Network (MLN) Matters Article MM5746
(Provider
instructions from CMS about HH PPS refinement changes) - The Proposed
Rule
and
supporting documentation - The Final
Rule
and Corrections
- Summary
of
Final PPS Refinement Changes compared to Current HH PPS Requirement - The Home Health & Hospice Medicare A Newslines for updates/additional clarifications on HH PPS refinement
Review
- CMS Presentation on HH PPS Refinement
claims processing changes - Handouts from the Cahaba teleconference, Reconstructing the Home Health Prospective Payment System (HH PPS) in 2008
- Cahaba HH PPS Refinement FAQs
Register for
- Cahaba educational events
- Listserv messages from the Cahaba
E-mail Notification Service and/or CMS
to
stay informed on HH PPS and other Medicare changes
Other Important HH PPS Links
- Claims Processing and Reimbursement Changes for Home Health Supplies
- Home Health Agency (HHA) Center

- Home Health Prospective Payment System (HH PPS)

- Home Health Prospective Payment System (HH PPS) Grouper Software and Documentation
- Treatment Authorization Code Structure (Quick reference tool HHAs can use to determine the configuration of the data elements contained in the Claim-OASIS Matching Key code generated for episodes beginning on or after January 1, 2008.)
- Home Health Prospective Payment System (HH PPS) Pricer
- Health Insurance Prospective Payment System (HIPPS) Code
- Outcome and Assessment Information Set (OASIS)
Page last updated: May 17, 2010