Home Health & Hospice Week

Industry Notes:

Check Out New Home Health Grouper, Payment Transmittal

Followup payment items related to the 2023 home health final rule are now out.

The updated PPS grouper that will take effect in January is at www.cms.gov/medicare/medicare-fee-for-service-payment/homehealthpps/casemixgroupersoftware. It includes updated threshold values for functional impairment levels for all clinical groups; updated functional impairment scoring for OASIS elements; updated clinical group assignment(s) for diagnosis codes, including the removal of clinical groups for some unspecified codes; updated comorbidity subgroup assignments for certain diagnosis codes; updated comorbidity subgroups applicable for the low comorbidity adjustment; and updated comorbidity subgroup interactions for high comorbidity adjustments, the Centers for Medicare & Medicaid Services notes.

www.cms.gov/files/document/mm12957-home-health-prospective-payment-system-cy-2023-update.pdf

And the transmittal that implements 2023 rate changes is at www.cms.gov/files/document/r11702CP.pdf, with the related MLN Matters article at www.cms.gov/files/document/ mm12957-home-health-prospective-payment-system-cy- 2023-update.pdf.

Remember: The already-scaled-back rural add-on expires as of Jan. 1, CMS notes in MM12957.

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