The final 2010 Medicare home health prospective payment system (HH PPS) rule established an annual limitation on Medicare outlier payments that can be paid to each home health agency (HHA). Specifically, effective January 1, 2010, outlier payments may comprise no more than 10% of the HHA’s total HH PPS payments for the year. CMS has issued instructions to contractors and a provider educational article about how the new policy is being implemented, including the use of a quarterly reconciliation process.