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  1. www.cms.gov › medicare › paymentHome Health PPS | CMS - Centers for Medicare & Medicaid Services

    Learn about Medicare Home Health payment policies such as consolidated billing, case-mix adjustments, and outlier payments.

  2. www.cms.gov › mlnproducts › downloadsHome Health Prospective Payment System - Centers for Medicare ...

    The Balanced Budget Act of 1997 (BBA) (Public Law 105–33), which was enacted on August 5, 1997, significantly changed the way Medicare pays for home health services. Until the implementation of the HH PPS on October 1, 2000, HHAs received payment under a retrospective reimbursement system.

  3. www.medicare.gov › coverage › home-health-servicesHome Health Services Coverage - Medicare

    Medicare Part B (Medical Insurance) cover eligible home health services as long as you need part-time or intermittent skilled services and you’re “homebound,” which means:

  4. www.cms.gov › medicare › paymentHome Health Patient-Driven Groupings Model | CMS - Centers for...

    One case-mix variable is the assignment of the principal diagnosis to one of 12 clinical groups to explain the primary reason for home health services. 30-day periods are categorized into 432 case-mix groups for the purposes of adjusting payment under the PDGM.

  5. www.medicare.gov › publications › 10969-medicare-and-home-health-careMedicare & Home Health Care

    How Medicare pays for home health care. Medicare pays for covered home health services you get during a 30-day period of care. You can have more than one 30-day period of care. Payment for each 30-day period is based on your condition and care needs.

  6. www.hhs.gov › MLN908143_2020_05_Medicare_Home_Health_Benefit_Booklet_FinalMedicare Home Health Benefit Booklet - HHS.gov

    Beginning March 1, 2020, certain practitioners may certify that patients are eligible for Medicare home health services, order these services, and establish and review home health plans of care (POCs).

  7. www.hhs.gov › MLN006816_2020_05_Home_Health_PPS_Booklet_FinalHome Health Prospective Payment System Booklet - HHS.gov

    Medicare pays HHAs one standardized payment for all the covered home health services and supplies provided to a patient within a 30-day period of care, as long as the patient is under a home health POC.

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