Home Health & Hospice

Q: How do we know if our claims would be a low utilization payment adjustment?

Homecare Insider, January 20, 2014

Q: How do we know if our claims would be a low utilization payment adjustment?
 
A: According to CMS:
 
An episode with four or fewer visits is paid the national per visit amount by discipline adjusted by the appropriate wage index based on the site of service of the beneficiary. Such episodes of four or fewer visits are paid the wage-adjusted per visit amount for each of the visits rendered instead of the full episode amount. The national per visit amounts by discipline (skilled nursing, home health aide, physical therapy, speech-language pathology, occupational therapy, and medical social services) are updated and published annually by the applicable market basket for each visit type.