HOME HEALTH AGENCY

Medicare pays for Home Health Care services on the basis of a prospective payment system that groups services into a 60-day episode of care. Payment for a specific episode is determined through a formal assessment of the patient’s condition and prognosis that is used to assign the patient into one of 80 Home Health Resource Groups (HHRGs). HHRGs reflect the severity of the patient’s condition, diagnoses and ability to function.

Medicare home health payment rates are based on a national per-episode payment amount adjusted by the weight of the HHRG and the cost or area wages. Payments can also be adjusted for episodes-of-care with few home health visits or high-cost outliers. Partial Episode Payments will also be applied to episodes that are interrupted because of change in patient status or discharge from the plan of treatment. 

NEWS

11/30/2007 :: Corrections to CY 2008 Medicare Home Health Agency PPS Final Rule released.

11/09/2007 :: CMS has released updated Home Health Case Mix Grouper software.

8/29/2007 :: CMS updates coding and billing information for OASIS assessments to aid the January 1, 2008, transition to the refined Home Health PPS payment groups.

8/29/2007 :: CY 2008 Medicare Home Health Agency PPS Final Rule is now available. Summary available to OHA members.