Advanced Search

Home Health & Hospice Week

Prospective Payment System:

2.3% Pay Cut Hits Freestanding For-Profits Hardest In 2012

Published on Mon Oct 04, 2010

Case mix changes reduce reimbursement rates for high-therapy episodes. The home care industry's call to halt cuts for so-called case mix creep fell on deaf ears at CMS. Medicare payment rates for home health agencies will fall 2.3 percent starting Jan. 1, the Centers for Medicare & Medicaid Services says in a 236-page final rule posted to the Federal Register website Oct. 31. The new base per episode rate will be $2,138.62 in non-rural areas and $2,202.68 in rural areas (see charts, p. 307, for NRS and per visit LUPA rates.) That's down from $2,192.07 and $2,257.83, respectively. CMS calculated the cut by reducing the 2.4 percent inflation update by 1 percent as required by law, then adding on a 3.79 percent cut for case mix creep -- an increase in case mix that CMS says isn't due to actual changes in patient acuity. The cut will strip $430 million from [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Home Health & Hospice Week

View All