Home Care PPS Final Rule Released November 1, 2011
On November 1, CMS released the final rule for Home Care PPS Billing. Despite talking about changes to the Case Mix Ratios there is no evidence that any such change took place. As you can see below the base rate was reduced but all of the visit, LUPA addon and supply rates went up slightly. Net is a -2.4 Percent change.
Based on the Site of Service for the Beneficiary
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CY 2011 National Standard i zed 60-Day Episode Payment Rate
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Multiply by the CY
2012 HH PPS payment update percentage of 1.4 percent
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Reduce by 3.79 percent f or nominal c hange in case -mix
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CY 2012 National Standard i zed 60-Day Episode Payment Rate.
|
|
$2,192.07
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x 1.014
|
x 0.9621
|
$2,138.52
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2. The per visit rates for LUPAs and the Non-Routine Supply rates are as follows:
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For HHAs that DO
submit the required quality data
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For HHAs that DO NOT
submit the required quality data
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|
Home Health Discipline Type
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CY 2011
Per- Visit Amounts Per
60-Day
Episode
|
Multiply by the CY
2012 HH PPS payment update percentage of 1.4 percent
|
CY 2012 per-visit payment
|
Multiply by the CY
2012 HH PPS payment update percentage of 1.4 percent minus 2 percentage points
(-0.6 percent)
|
CY 2012 per-visit payment
|
|
HH Aide
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$50.42
|
X 1.014
|
$51.13
|
X 0.994
|
$50.12
|
|
MSS
|
$178.46
|
X 1.014
|
$180.96
|
X 0.994
|
$177.39
|
|
OT
|
$122.54
|
X 1.014
|
$124.26
|
X 0.994
|
$121.80
|
|
PT
|
$121.73
|
X 1.014
|
$123.43
|
X 0.994
|
$121.00
|
|
SN
|
$111.32
|
X 1.014
|
$112.88
|
X 0.994
|
$110.65
|
|
SLP
|
$132.27
|
X 1.014
|
$134.12
|
X 0.994
|
$131.48
|