An Update on Sequester Reimbursment Rates from CMS

The Centers for Medicare & Medicaid Services has made a clarification regarding sequester reimbursement rates. As a follow-up to the article from earlier in the week on this topic, please review the following information, which CMS recently provided.

The sequestration that takes effect on April 1, 2013 will be implemented as follows:

Home Health Services: The 2% payment reduction will be applied to episodes with end dates of April 1 and later.

Hospice: The claim “through date” which is generally meaning that with calendar month billing, services beginning April 1, 2013.

Below is the specific response from CMS:

“The answer to your question on home health payments is that, working just like the annual update to HH PPS payments, CMS will use the “Claim Through” date, on the claim, to apply the reductions. For home health, that is also considered the “end of episode” date. If the “Claim Through” date (i.e. end of episode date) is on or after the effective date of the reduction (April 1, 2013), the reduction will apply. Similarly, for hospices, CMS will use the claim “Through” date to apply the reductions.”

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