Home Health & Hospice Week

Don’t let mismatched HIPPS codes on your Requests for Anticipated Payment and final claims slow down your billing.

Reminder: As of Jan. 1, 2021, “HIPPS codes are still required on RAPs and an HHA may submit any valid HIPPs code,” HHH Medicare Administrative Contractor CGS explains in a new post to its website. “For the final claim, the 0023-revenue code line must be reported with the HIPPS code that was reported on the RAP. The first four positions of the code must be identical to the value reported on the RAP. This allows the system to match the claim with the corresponding RAP.”

However, remember that you can use a dummy placeholder code on both the RAP and final claim. “RAPs can be submitted with any valid HIPPS code. The claim is then submitted with the HIPPS code that was reported on the RAP,” CGS explains in its home health billing frequently asked questions. “The grouping to determine the HIPPS code used for final payment will occur in Medicare systems. At that time, the submitted HIPPS code on the claim will be replaced with the system-calculated code.”