Home Health Reminder and CMS Update to PDGM Split Implementation Instructions

REMINDER: Home Health RAPs Hold Medicare Administrative Contractors (MACs) typically hold claims for a brief period each quarter when they implement system releases. This January, home health Requests for Anticipated Payment (RAPs) are affected by implementation of the Home Health Patient-Driven Groupings Model. MACs will hold RAPs with From Dates on or after January 1,…

CMS Updates Providers on PDGM and Quality Reporting Program

The Centers for Medicare & Medicaid Services (CMS) held a Home Health, Hospice & DME Open Door Forum yesterday where CMS representatives provided information on the new Home Health Patient Driven Grouping Model (PDGM), the home health quality reporting program and the Hospice Quality Reporting Program.¬† A summary of the information shared is below. Home…

CMS Issues Instructions for PDGM Claims Processing

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 11081, which provides claim processing¬† instructions to the Medicare Administrative Contractors ( MACs) that will be necessary to process home health claims with the implementation of the Patient Driven Groupings Model (PDGM). The PDGM will assign 30-day periods of care into one of…