CMS is Requiring HIPPS Codes on Medicare Advantage Claims

The following article was published on the National Association for Home Care and Hospice (NAHC) website on June 19, 2013:

Effective July 1, 2013 home health agencies will be required to include a Health Insurance Prospective Payment System (HIPPS) code on Medicare Advantage (MA) claims. The Centers for Medicare & Medicaid Services (CMS) has instructed MA organizations to reject any home health claim that does not include a HIPPS code. According to a CMS communication with the health plans, CMS is requiring the HIPPS codes on home health claims in order to accurately price home health encounters.

CMS has not provided any direct communication with the provider community. Several agencies have been informed of this requirement through communications from their contracted MA plans. However, many agencies have not received any communication.

To read the full article, go to the NAHC website.

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