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Delta Connect Blog

CMS Issues Final Rule for HH PPS

Posted by Crystal Parks on Oct 31, 2014 8:50:16 AM


On October 30, 2014, the Center for Medicare & Medicaid Services (CMS) issued the final rule for Medicare's HH PPS payment rates and wage index for calendar year 2014. 

The biggest change is in regards to the therapy reassessments. The final rule states therapy reassessments need to take place every 30 calendar days, rather than every 14 calendar days as proposed in July. 

The final rule still shows a 0.30% reduction to overall Medicare reimbursement. The calculations do not include the 2% sequestration reduction currently in effect through March 2015. 

The final 2014 PPS rule still contains the removal of the narrative requirement for physician face-to-face visits. The certifying physician will still be required to certify that a face-to-face patient encounter occurred and to document the date of the encounter.

CMS also finalized that if any agency's claim is denied, the corresponding physician claim for certifying/recertifying patient eligibility for home health is also considered non-covered as well.

CMS clarified that face-to-face encounters are required for certifications rather than initial episodes - and that certifications are generally considered any time a new start of care assessment is conducted to initiate patient care. 

CMS received 337 comments from industry providers, clinicians, organizations, consulting firms and associations. 

Read about the other changes in the final PPS rule here


Topics: HHPPS


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