tci Medicare Compliance & Reimbursement - 2015 Issue 13

Industry Notes: Wait Until October for These Home Health Payment Fixes

If you’ve seen problems with your home health agency claims re-coding incorrectly this year, you aren’t alone. Medicare is fixing the issue — but not until the fall. Problem #1: The 2015 HH Pricer currently uses a table that contains incorrect case-mix weights for all HIPPS codes beginning with “4,” the Centers for Medicare & Medicaid Services (CMS) explains in recent MLN Matters article MM9198. “The weights for all codes beginning with ‘4’ are using the weight for the corresponding code that begins with ‘2’ (for example, a claim submitted with HIPPS...

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