Home Health PPS

Home Health Transmittals

The list below shows the transmittals that are directed to the Home Health provider community, but the list may not include all instructions for which Home Health providers are responsible. For a list of all instructions, view the Transmittals web page under Regulations and Guidance.

CR # Release Date Subject MLN Article #
5423 12/15/2006 Home Health Prospective Payment System Update for Calendar Year 2007 MM5423
5419 12/22/2006 Provider Migration N/A
7256 12/17/2010 Implementation of Home Health Agency (HHA) Payment Safeguard Provisions MM7256
7182 12/17/2010 Additions To and Revisions of Existing G-Codes for the Reporting of Skilled Nursing Services and Skilled Therapy Services in the Home Health or Hospice Setting N/A
5738 10/16/2007 Instructions for the Implementation and Execution of the Medicare Provider Enrollment Demonstration for Home Health Agencies (HHAs) in High-Risk Areas N/A
5782 11/02/2007 Automate Adjustments to Home Health Agency (HHA) and Managed Care (MC) Common Working File (CWF) Informational Unsolicited Responses (IURs) N/A
6757 02/05/2010 Coding Patient Transfers Under the Home Health Prospective Payment System MM6757
6955 04/23/2010 Temporary 3 Percent Rural Add-On for the Home Health Prospective Payment System MM6955
6856 04/28/2010 Expansion of the Current Scope of Editing for Attending Physician Providers for Free-Standing and Provider-Based Home Health Agency Claims Processed by Medicare Regional Home Health Intermediaries MM6856
6897 04/28/2010 Remittance Advice Coding to Identify Claims Subject to the Limitation on Home Health Prospective Payment System Outlier Payments MM6897
6909 04/28/2010 Update to the HCPCS Codes for Payment of Surgical Dressings in Indian Health Service Providers MM6909
6911 04/28/2010 Enhancements to Home Health Consolidated Billing MM6911
7169 01/21/2011 Improved Processing of Oxygen Services on Home Health Claims MM7169
5597 06/29/2007 IOM Pub 100-09, Chapters 3, Provider Inquiries and Chapter 6 - Provider Customer Service Program Updates MM5597
5597 07/13/2007 IOM Pub. 100-09, Chapters 3- Provider Inquiries and Chapter6- Provider Customer Service Program Updates N/A
7182 02/08/2011 Additions To and Revisions of Existing G-Codes for the Reporting of Skilled Nursing Services and Skilled Therapy Services in the Home Health or Hospice Setting MM7182
5776 11/02/2007 Validation of Non-Routine Supply Reporting on Home Health Prospective Payment System (HH PPS) Claims MM5776
5829 12/14/2007 Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement MM5829
5979 04/18/2008 Assignment of Providers to MACs MM5979
6027 05/16/2008 Correction to Determinations of Early vs. Later Episodes Under the Home Health Prospective Payment System (HH PPS) MM6027
5551 04/20/2007 Home Health Agencies (HHAs) Providing Durable Medical Equipment (DME) in Competitive Bidding Areas MM5551
6911 06/14/2010 Enhancements to Home Health (HH) Consolidated Billing MM6911
6982 06/18/2010 Medical Review Resolutions in the Absence of a Plan of Care (POC) and the Outcome Assessment Information Set (OASIS) N/A
7014 07/30/2010 Home Health Agencies (HHAs)Providing Durable Medical Equipment(DME)in Competitive Bidding Areas MM7014
5877 02/01/2008 Correction to Low Utilization Payment Adjustment Add-on Payments Under the Refined Home Health Prospective Payment System (HH PPS) MM5877
6856 08/27/2010 Expansion of the Current Scope of Editing for Attending Physician Providers for Free-Standing and Provider-Based Home Health Agency(HHA) Claims Processed by Medicare Regional Home Health Intermediaries (RHHIs) MM6856
5868 02/01/2008 Update to the Implementation Date for Home Health Agencies (HHAs) Providing Durable Medical Equipment (DME) in Competitive Bidding Areas N/A
7114 09/03/2010 Calendar Year 2011 Payments to Home Health Agencies That Do Not Submit Required Quality Data N/A
6856 09/28/2010 Expansion of the Current Scope of Editing for Attending Physician Providers for Free-Standing and Provider-Based Home Health Agency(HHA) Claims Processed by Medicare Regional Home Health Intermediaries (RHHIs) MM6856
6856 10/08/2010 Expansion of the Current Scope of Editing for Attending Physician Providers for Free-Standing and Provider-Based Home Health Agency (HHA) Claims Processed by Medicare Regional Home Health Intermediaries (RHHIs) MM6856
5903 02/08/2008 Additional Instructions for the Execution of the Medicare Provider Enrollment Demonstration for Home Health Agencies (HHAs) in High-Risk Areas N/A
5879 02/07/2008 Home Health Prospective Payment System (HH PPS) Refinement and Rate Update for Calendar Year (CY) 2008 MM5879
5551 05/25/2007 Home Health Agencies (HHAs) Providing Durable Medical Equipment (DME) in Competitive Bidding Areas N/A
6002 07/25/2008 Clarification on the Correct Condition Code to Report on Provider Adjustment Requests to Indicate a Health Insurance Prospective Payment System (HIPPS) Code Change N/A
7374 04/15/2011 Home Health Therapy Services MM7374
7396 04/29/2011 Home Health Requests for Anticipated Payment and Timely Claims Filing N/A
5877 03/07/2008 Correction to Low Utilization Payment Adjustment Add-on Payments Under the Refined Home Health Prospective Payment System (HH PPS) MM5877
7395 05/06/2011 Corrections to Home Health Prospective Payment System (HH PPS) Outlier Limitation N/A
7374 05/06/2011 Home Health Therapy Services N/A
6512 07/24/2009 Revised Processing of Osteoporosis Drugs Under the Home Health Benefit MM6512
6512 09/18/2009 Revised Processing of Osteoporosis Drugs Under the Home Health Benefit MM6512
6669 10/02/2009 Home Health Agency (HHA) Provider Enrollment Revalidation N/A
6662 10/09/2009 Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcemen MM6662
6732 11/20/2009 Home Health Agency (HHA) Capitalization Requirements N/A
6747 12/04/2009 Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year 2010 MM6747
6759 12/23/2009 Limitation on Home Health Prospective Payment System (HH PPS) Outlier Payments MM6759
6750 12/18/2009 Implementation of Home Health Agency Program Safeguard Provisions MM6750
7338 05/27/2011 Revisions to Ch. 10, Home Health Agency Billing MM7338
7478 10/07/2011 Hospice Claims Processing Procedures When Required Face-to-Face Encounters Do Not Occur Timely MM7478
7459 10/14/2011 Calendar Year 2012 and After Payments to Home Health Agencies That Do Not Submit Required Quality Data MM7459
7544 10/28/2011 Processing Multiple Home Health Unsolicited Responses N/A
7329 02/16/2011 Clarifications for Home Health Face-to-Face Encounter Provisions SE1038
7599 11/08/2011 Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement MM7599
7253 12/28/2010 Home Health Prospective Payment System Rate (HH PPS) Update for Calendar Year (CY) 2011 MM7253
7323 12/01/2011 Home Health Advance Beneficiary Notice, (HHABN), Form CMS-R-296 N/A
7660 12/22/2011 Additional Instructions Regarding Demand Bills Under the Home Health Prospective Payment System MM7660
7704 2012-02-03 International Classification of Diseases-10th Edition (ICD-10), Inclusion of Type of Bill (TOB) 33X, Home Health, Outpatient (includes HHA visits under a Part A Plan of treatment) MM7704
7657 11/23/2011 Home Health Prospective Payment System Rate (HH PPS) Update for Calendar Year (CY) 2012 MM7657
7760 2012-04-27 Systematic Validation of Payment Group Codes for Prospective Payment Systems(PPS) Based on Patient Assessments MM7760
7833 2012-05-11 Calendar Year 2013 and After Payments to Home Health Agencies That Do Not Submit Required Quality Data MM7833
7841 2012-05-11 July 2012 Integrated Outpatient Code Editor (I/OCE) Specifications Version 13.2 MM7841
7760 2012-07-18 Systematic Validation of Payment Group Codes for Prospective Payment Systems (PPS) Based on Patient Asssessment.