Sharon Hamilton MS, RN, CFDS
Clinical Consultant, Briggs Healthcare
Contrary to Question #7 in the Review Choice Demonstration (RCD) for Home Health (HH) Services Frequently Asked Questions (FAQ) (updated 01/06/20), RCD is applicable to billing periods not episode of care!
RCD is scheduled to start in Texas on March 2, 2020. Agencies will need to understand that applicable billing periods within an episode include clients admitted prior to March 2, 2020, on service now, are subject to pre-claim or post-payment review depending upon the choice selected.
Applicable billing periods will be those periods occurring on or after March 3rd. The PCR documentation and billing UTN will be required, at that time. Failure to apply your RCD choice to the applicable billing period will be subject to a Pre-claim ADR and a 25% reduction, according to Palmetto GBA.
Providers wanting to learn more should look for further guidance from CMS.
Source: Texas Association for Home Care and Hospice