Review Choice Demonstration (RCD) Updated Cycles for Providers in Illinois and Texas

Important information from Palmetto GBA:

“CMS will restart the RCD following the pause for COVID-19. Home Health claims in all demonstration states with billing periods on or after August 31, 2020, will be subject to review under the requirements of the choice selected.   

Illinois

RCD Cycle 2 for providers in the state of Illinois has been updated due to the COVID-19 pause.  Cycle 2 began on February 1, 2020, and paused after two months.  Recently, Palmetto GBA communicated that the remaining four months of the Cycle would begin on August 31, 2020 and end on December 31, 2020. After considering additional stakeholder feedback, CMS has determined that Cycle 2 will now end on September 30, 2020.

Affirmation and Claim Approval rates for Illinois will be calculated based on review decisions made between February 1, 2020, and September 30, 2020. Palmetto GBA will communicate Cycle 2 results to all providers no later than October 31, 2020. Please review this updated information for Illinois and share it with your staff.

Texas

RCD Cycle 1 for providers in the state of Texas has also been updated due to the COVID-19 pause. Cycle 1 began on March 2, 2020, and paused after one month. Recently, Palmetto GBA communicated that the remaining five months of the Cycle would begin on August 31, 2020 and end on January 31, 2021. After considering additional stakeholder feedback, CMS has determined that Cycle 1 will now end on September 30, 2020.

Affirmation and Claim Approval rates for Texas will be calculated based on review decisions made between March 2, 2020, and September 30, 2020.  Palmetto GBA will communicate Cycle 1 results to all providers no later than October 31, 2020. Please review this updated information for Texas and share it with your staff.

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