Home Health Case Mix Grouper Software Package and Documentation

On December 18, 2007, CMS alerted the public that revisions to the HH PPS Grouper were pending. As a follow-up to that announcement and to CMS's posting of the revised final documentation (grouper logic/pseudocode, associated tables, readme file, a summary of pseudocode and software changes, and test cases) on January 28, 2008, CMS is now providing the revised final grouper software (.DLL). This final version of the grouper software replaces the version previously posted on November 16, 2007. Included in the software download is the README file (which was also part of the revised final documentation download) describing the entire contents of the revised grouper software and documentation. {See "Revised Final Grouper Software (posted January 31, 2008)" in the Downloads section below.}

CMS is providing guidance to home health agencies (HHAs) on two issues related to the implementation of the refined HH PPS effective 1/1/2008: 1) Billing options for HHAs whose systems are not ready to bill, based on the refined HH PPS,on 1/1/2008;   2) Upcoming revisions to the HH PPS Grouper, which may result in underpayments to HHAs, and the options available to HHAs on how to handle those potential underpayments.  CMS will be releasing the revised grouper, HAVEN and associated pseudo code as soon as possible in 2008. Please see the Guidance to Home Health Agencies in the downloads section below. (posted December 18, 2007)

CMS is updating the HH PPS Grouper. The primary reason for this update is changes in ICD-9-CM coding (effective October 1, 2008). CMS is providing an updated HH PPS Grouper Software Package (Version 2.03). These materials include the updated GROUPER.DLL software module, an updated version of the grouper logic (pseudocode) and associated tables, and updated test cases to be used by those who are developing their own software to implement the grouper logic. The changes to the grouper are described in the README file
(READM203.PDF) included in the updated package. (posted September 23, 2008)

Downloads
Revised Final Grouper Software (Posted 9/23/08) [ZIP 296KB] Revised Final Documentation and Test Case Files (Posted 9/23/08) [ZIP 3.4MB] Guidance to Home Health Agencies  (posted December 18, 2007) [PDF, 47KB]
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Page Last Modified: 09/23/2008 8:10:40 AM
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