Home Health & Hospice Week

Industry Note:

Check Out Latest RCD-PDGM Clarification

Update confirms doubling of RCD workload.

Home health agencies in Review Choice Demonstration states got an eleventh-hour explanation for how RCD will work in conjunction with the Patient-Driven Groupings Model.

On Dec. 19, the Centers for Medicare & Medicaid Services posted this update to p. 11 of its RCD Operational Guide: “For claims with dates of service of 1/1/2020 and after, HHAs will need to submit a PCR for each 30-day billing period. When requesting more than 30 days of services, the HHA can select the multiple episode/billing period option and submit two or more 30-day billing periods at the same time. In eServices, HHAs can select multiple episode(s)/billing periods once all tasks are completed for episode/billing period 1. For multiple episodes/billing periods, HHAs should enter the episode/billing period start and end dates, type of bill, HCPCS codes, and upload the POC, if changed, or refer back to the POC (Task 3) for episode/billing period 1. Each 30-day request will generate a separate UTN. When submitting the 30-day billing periods separately, all documentation for the episode must be submitted regardless if it is the first 30 days in the episode or the second 30 days in the episode.”

The National Association for Home Care & Hospice expected to see CMS communicate the information in a new Frequently Asked Question, it says in a message to members.

The addition confirms that “HHAs will need to submit a PCR for each 30-day billing period,” NAHC emphasizes.

The updated manual is at www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Review-Choice-Demonstration/Downloads/RCD-Operational-Guide.pdf.

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