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    CMS Releases Medicare Home Health Final Rule for 2014

    The Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System for 2014. The rule affects services provided by home health agencies under Medicare Part A beginning January 1, 2014.

    The national standardized 60-day episode payment for 2014 is set at $ 2,869.27, and the national per-visit rate for CY 2014 for physical therapy services is $132.40. CMS projects that Medicare payment to home health agencies in calendar year 2014 will be reduced by $200 million.

    The rule finalizes the following policies:

    • Home health payment rates will see an updated market basket increase of 2.3% that is in turn reduced through home health rebasing.
    • As a result of rebasing, a $80.95 (3.5%) reduction will be applied to the national standardized 60-day episode payment rate each year from 2014 - 2017.
    • Three Low-Utilization Payment Adjustment (LUPA) add-on factors will be used in calculating the LUPA. This affects skilled nursing, physical therapy, and speech-language pathology when that discipline is the first skilled visit in a LUPA episode—either as the only episode or an initial episode among adjacent episodes.
    • A total of 170 ICD-9-CM diagnosis codes will be removed within home health PPS Grouper diagnosis groups.
    • Two claims-based measures will be adopted: Re-hospitalization during the first 30 days of home health and emergency department use without hospital readmission during the first 30 days of home health.
    • Payments to rural home health areas will be increased by 3 percent and applied to the national standardized 60-day episode payment rate.

    The policies in the final rule will become effective January 1, 2014. APTA will provide a full summary of the final rule in the coming days.


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