Agency Compliance

The White House recently said that the current public health emergency (PHE) would “likely” last through the entirety of 2021. For now, blanket waivers have relaxed industry regulations, offering provider relief, but it is not time to rest on your laurels. Wisdom dictates that agencies...

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Review Choice Demonstration

Top 3 Strategies For Success 

An update on the Centers for Medicare & Medicaid Services (CMS) website warns providers that they are continuing phase-in participation, through March 31, 2021, for Florida and North Carolina. This concession on the part of CMS allows agencies in these states some flexibility. 

On November 4, 2020 the Centers for Medicare and Medicaid Services (CMS) published the final rule for 2021. Overall the changes this year were minimal since this was the first year for the Patient-Driven Groupings Model (PDGM) and there is not enough data to support significant changes. Furthermore, the COVID pandemic affected industry operations which mitigated reform to the PDGM payment structure. Agencies should review the changes affecting their operations from the fifty-nine-page rule, but here is a quick glance at the updates:

Can home health care agencies bill Medicare Part B for outpatient services? 

 

Outpatient Therapy Services BillingYes. According to CMS, outpatient therapy services may be provided by a home health agency to patients who are not homebound or otherwise are not receiving services under a home health plan of care (POC). These services are not paid under the Home Health Prospective Payment System (HH PPS). The reimbursement for the outpatient therapy services is calculated using the Medicare Physician’s Fee Schedule (MPFS).