CMS Releases the 2020 Home Health Final Rule

CMS issued a final rule that finalizes routine updates to the home health payment rates for 2020. This rule also includes: a modification to the payment regulations pertaining to the content of the home health plan of care; allows therapist assistants to furnish maintenance therapy; and finalizes policies related to the split percentage payment approach under the Home Health Prospective Payment System (HH PPS). Additionally, the rule includes final policies related to the implementation of the permanent home infusion therapy benefit in 2021, including payment categories, amounts, and required and optional adjustments, and solicits comments on options to enhance future efforts to improve policies related to coverage of eligible drugs for home infusion therapy.

Some of the most important features of the Final Rule are:

  • PDGM’s much maligned behavioral assumption adjustment has dropped to 4.36%, down from the 8% cut that was proposed.
  • A 1.3% overall increase in Medicare reimbursement (although most agencies, especially therapy-heavy ones, will see a net drop in revenue under PDGM)
  • Finalization of the proposed elimination of RAPs, which will occur in phases. Once RAPs are gone, agencies will be required to submit a Notice of Admission (NOA) beginning in 2022.

CMS has issued a press release as well as a fact sheet on the new rule. If you would like to read all 500+ pages in full, click here to view the final rule on the Federal Register.

We will break down what the final rule means for your agency in our upcoming issue of Home Health Today. If you would like to receive a copy at no charge, please contact us today!