Alert for CHHAs on Payment Codes

The Centers for Medicare and Medicaid Services (CMS) posted a Special Edition of MLN Matters on "Payment Codes on Home Health Claims Will Be Matched Against Patient Assessments." As per the article, beginning Wed., April 1, 2015, Medicare systems will cross-walk the Health Insurance Prospective Payment System (HIPPS) code on the Medicare home health claim to the HIPPS code generated by the corresponding OASIS assessment before the claim is paid. As per this new announcement, if the HIPPS code from OASIS differs, then Medicare will use the OASIS-calculated HIPPS code for payment.  In this article it states that home health agencies do not need to make any changes to their billing systems. It also includes official instructions that were provided to your Medicare Administrative Contractor (MAC), recommendations from the Office of the Inspector General and contacting your MAC with questions.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871