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2008 Case-Mix Refinement to the Home Health Prospective Payment System (HH PPS)

HH PPS Refinement Resources

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  • Change Request 6393 Globe to indicate www link. (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 Globe to indicate www link.(Provider instructions from CMS about ensuring that changes to non-routine supply severity levels on HH PPS claims are appropriate)
  • Change Request 6305 Globe to indicate www link. (Correction to HH PPS episode sequence edits)
  • Medicare Learning Network (MLN) Matters Article MM6305  Globe to indicate www link. (Provider instructions from CMS the system changes to correct HH PPS episode sequence edits.)
  • Change Request 6283 Globe to indicate www link. (System change to exclude Low Utilization Payment Adjustments (LUPAs) from HH PPS episode sequence editing)
  • Change Request 6250 Globe to indicate www link. (Claim adjustments by RHHIs to correct errors associated with the implementation of HH PPS case-mix refinement)
  • Medicare Learning Network (MLN) Matters Article MM6250 Globe to indicate www link.(Provider instructions from CMS about RHHI claim adjustments to correct errors associated with the implementation of HH PPS case-mix refinement)
  • Change Request 6027 Globe to indicate www link. (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 Globe to indicate www link. (Provider instructions from CMS about excluding fully denied episodes by medical review when counting adjacent episodes)
  • Change Request 5877  Globe to indicate www link.  (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 Globe to indicate www link.(Provider instructions from CMS about application of LUPA add-on amounts)
  • Change Request 5776  Globe to indicate www link. (Written instructions from CMS for system editing of non routine supplies (NRS) on “refined” HH PPS claims)
  • Medicare Learning Network (MLN) Matters Article MM5776 Globe to indicate www link. (Provider instructions from CMS about NRS editing on HH PPS claims)
  • Change Request 5746 Globe to indicate www link. (Written instructions from CMS for submitting claims under the refined PPS requirements)
  • Medicare Learning Network (MLN) Matters Article MM5746 Globe to indicate www link. (Provider instructions from CMS about HH PPS refinement changes)
  • The Proposed Rule Globe to indicate www link. and supporting documentation
  • The Final Rule Globe to indicate www link. and Corrections Globe to indicate www link.
  • Summary Globe to indicate www link. 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

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Page last updated: May 17, 2010

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