Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
In a report, the Office of Inspector General found that Medicare improperly paid some claims for home health services with 5–7 visits in a payment episode. Review home health prospective payment system (PPS) information to properly bill for services slightly above the low utilization payment adjustment threshold.
Visit the Home Health PPS webpagefor additional resources and the latest policy and payment updates:
- Calendar Year 2021 Home Health PPS final rule
- Section 10.6 Medicare Benefit Policy Manual, Chapter 7 (PDF)
- Section 10.1.17 Medicare Claims Processing Manual, Chapter 10 (PDF)
- Section 6.2 Medicare Program Integrity Manual, Chapter 6 (PDF)