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March 16, 2015

Reminder: Special CBSA Code for Home Health Claims

The Home Health & Hospice Provider Contact Center (PCC) has received an increase in calls from home health agency (HHA) providers regarding Core Based Statistical Area (CBSA) codes. 

On March 4, 2015, the article, “Special CBSA Codes for Home Health Claims” was sent in a listserv message and posted on the News page of the Home Health & Hospice website.  This article informed home health agencies that for beneficiaries serviced in areas where there is more than one unique Core Based Statistical Area, the HHA should use one of the special CBSA Codes in the range 50xxx on the claim.  This affects home health claims with a ‘through’ date of January 1, 2015, and after.

To determine if you should submit a special CBSA code, follow the steps below.

  1. Access the Home Health Payments Rates Web page.
  2. Click on the “Calendar Year 2015 Rates By County” link to open the “CY-2015-Final-Wage-Index” zip file.
  3. The zip file contains four Excel files.  To access a more readable file, select the second “CY 2015 Final wage index” file that is listed (shown below). 

    excel files

  4. Once the Excel file is open, refer to the last column (column L), “CBSA Number or Alternate Number that would go in the CBSA field on the claim.”  Report the CBSA code that is appropriate for the location where the beneficiary received their services.

HHAs that have claims with a through date of January 1, 2015, and after, which were paid incorrectly due to the wrong CBSA code should submit an adjustment.

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