December 17, 2015
Adjustments to Correct Home Health Claim Payments
Medicare contractors have identified an incorrect payment calculation affecting home health claims. Claims reporting Health Insurance Prospective Payment System (HIPPS) codes beginning with 5 are not being recoded correctly when fewer than 20 therapy services are provided. These errors affect only home health claims with receipt dates on or after October 1, 2015. CMS expects Medicare systems to be corrected by January 4, 2016. Home health agencies do not need to take any action. Medicare Administrative Contractors will adjust the claims to correct payments.