CMS Guidance on HIPPS Codes for SNF and HHA Medicare Advantage Billing

The latest guidance from the Centers for Medicare and Medicaid Services (CMS) on the new requirement to include Health Insurance Prospective Payment System codes (HIPPS) on Medicare Advantage Organization (MAO) claims submissions is available by clicking here.  Although this mandate has been postponed several times, July 1, 2014 remains the effective date for MAOs to submit HIPPS codes with their skilled nursing facility (SNF) and home health agency (HHA) claims.  This impacts claims with dates of service on or after July 1.

CMS has revised their guidance to the MAOs, hopefully minimizing the administrative burden on the SNFs and HHAs.  Please refer to the above linked document for more details.  Some questions still remain as to exactly how the new mandate can be met, and LeadingAge NY is seeking some additional clarification.  In the meantime, impacted providers should be communicating with their MAOs to ensure that they are meeting their claims submission requirements.  Previous LeadingAge guidance on this is available by clicking here.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827