Medicare Home Health Payments

On November 3, 2008, CMS published a notice updating the 60-day national episode rates and the national per-visit amounts under the Medicare home health prospective payment system (HH PPS), effective January 1, 2009. The notice includes a 2.9 percent home health market basket increase, but this increase is largely offset by a 2.75 percent reduction to the HH PPS rates to account for the changes in case-mix that are unrelated to patient’s health status (the second year of a four-year phase-in) and an adjustment to the wage index for 2009. CMS estimates that overall Medicare home health payments will increase by a total of $30 million in CY 2009. As mandated by the Deficit Reduction Act of 2005, if a home health agency does not submit quality data, the home health market basket percentage increase will be reduced 2 percentage points. The required quality measures for meeting the submission requirements for CY 2009 are the same as those used for CY 2008.

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