Iowa HHA: Home Health Agency Low-Utilization Payment Adjustment (LUPA) Reimbursement Rates

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

Iowa Department of Human Services (DHS) and Iowa Medicaid Enterprise (IME) posted INFORMATIONAL LETTER NO. 2250-MC-FFS on August 3, 2021.  The IL is directed to Iowa Medicaid Home Health Agencies and is effective July 1, 2021.

Provisions of the 2021 Iowa Acts, House File 891, Section 31, required DHS to implement an increase to LUPA reimbursement rates for skilled nursing, physical therapy, occupational therapy, speech therapy, home health aide, medical social services, and home health care for maternity patients and children effective July 1, 2021.

For updated Iowa Administrative Code (IAC) rules regarding payment methodologies, please refer to IAC 441-79.1(2) at https://www.legis.iowa.gov/DOCS/ACO/IAC/LINC/Chapter.441.79.pdf.[i]

The Home Health Agency fee schedule will be updated to reflect the new reimbursement rates for the services listed above. Fee schedules may be accessed on the DHS website at https://dhs.iowa.gov/ime/providers/csrp/fee-schedule.[ii]

Please note: Due to the provider challenges related to the COVID-19 Public Health Emergency, the Department has made an exception to our normal process in allowing provider rate increases prior to approval from the Centers for Medicare and Medicaid Services (CMS) and State Plan Amendment (SPA) submission. The IME appreciates your partnership as we work together to serve the needs of Iowa Medicaid members. If you have any questions, please contact the IME Provider Services Unit at 1-800-338-7909, locally at 515-256-4609, or by email at imeproviderservices@dhs.state.ia.us.


[i] https://www.legis.iowa.gov/DOCS/ACO/IAC/LINC/Chapter.441.79.pdf

[ii] https://dhs.iowa.gov/ime/providers/csrp/fee-schedule