U S Department of Health and Human Services Improving the health, safety and well-being of America
  CMS Home > Medicare > Home Health PPS > Coding and Billing Information

Coding and Billing Information

Home Health PPS Coding and Billing Information includes:

  • Information regarding HH PPS Case-Mix Refinements - See "Downloads" section below.
    • Answers regarding transition episodes.   This document describes special steps for HHAs to take in completing their OASIS assessments at the transition to the refined HH PPS January 1, 2008. These steps will assure HHAs can create the proper payment group code for their claims.
    • HH PPS HIPPS code weight table.  These spreadsheets map each of the 1836 new HIPPS code for the refined HH PPS to its associated case-mix weight and supply payment amount.   
    • Presentation on HH PPS claims processing changes.   An outline describing the principle changes to HHA coding and billing that result from the refined HH PPS.
  • Home Health PPS Grouper Software and Documentation - See "Related Links Inside CMS" below.
  • Health Insurance Prospective Payment System (HIPPS) Codes - See "Related Links Inside CMS" below.
  • Home Health PC Pricer - Program used by CMS to calculate Home Health Resource Group (HHRG) rates and all applicable adjustments. The link below also includes a user manual for the program. See "Related Links Inside CMS" below.
  • Home Health Consolidated Billing Master Code List - An Excel workbook file containing complete lists of all codes ever subject to consolidated billing provision of HH PPS. A master list worksheet shows the dates each code was included and excluded from consolidated billing editing on claims, with associated CMS transmittal references. The master list also associates each code with any related predecessor and successor codes. Supplemental worksheets show the list of included codes for each CMS transmittal to date. See "Downloads" section below.
  • CY 2010 Home Health PPS Wage Index File - See "Downloads" section below.
Downloads

Answers Regarding Transition Episodes [PDF 34KB]

HH PPS HIPPS Code Weight Table [ZIP/CSV 78KB]

Presentation on HH PPS Claims Processing Changes [PDF 138KB]

Medicare Home Health Diagnosis Coding [PDF, 11KB]

Home Health Consolidated Billing Master Code List [ZIP, 169KB] - Updated 11/5/09

CY 2010 Home Health PPS Wage Index File [ZIP, 37KB]
Related Links Inside CMS

Home Health PPS Grouper Software and Documentation

Health Insurance Prospective Payment System (HIPPS) Codes

Home Health PC PRICER

OASIS - (Attachment D: Selection & Assignment of OASIS Diagnosis) Guidance
Related Links Outside CMSExternal Linking Policy

There are no Related Links Outside CMS

 

Page Last Modified: 11/05/2009 10:46:26 AM
Help with File Formats and Plug-Ins

Submit Feedback




www1