CHA News

CMS Issues CY 2021 Home Health PPS Final Rule

For CFOs, home health leaders, directors of reimbursement

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The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for the home health prospective payment system (PPS) for calendar year (CY) 2021. 

CMS estimates that Medicare payments to home health agencies in CY 2021 will increase by 1.9% ($390 million), reflecting a 2% update adjusted by a 0.1% decrease in payments due to mandated reductions in the rural add-on percentages.

This rule also finalizes proposed updates to the home health wage index. Additionally, it finalizes and makes permanent certain changes originally implemented in association with the COVID-19 public health emergency, including the use of telecommunications technologies to provide care to Medicare beneficiaries, though such use cannot be considered a visit for the purpose of patient eligibility or payment.   

The rule also updates the infusion therapy benefit for CY 2021, including enrollment policies for qualified home infusion therapy suppliers and updates to payment rates, and finalizes certain policies associated with home health value-based purchasing model, which is currently under way in several states, not including California.