Posts tagged ‘hh pps’

December 30, 2011

Gait impairment may impact M1850

CMS has provided some guidance on gait impairment and its potential impact on M1850 …

Question: When completing M1850, Transferring, do I consider the patient’s gait impairment if they must ambulate 12 feet from the bed to get to the closest sitting surface and the need for assistance of another person?
CMS Answer: The need for assistance with gait may impact the M1850, Transferring score if the closest sitting service applicable to the patient’s environment is not next to the bed. M1850 reports the patient’s ability to move from the supine position in bed (or the routine sleeping surface) to a sitting position at the bedside, then some type of standing, stand-pivot, or sliding board transfer to a sitting surface at the bedside. If there is no chair at the bedside, report the ability to transfer from the sleeping surface to whatever sitting surface is applicable to the patient’s environment and need.

If the sleeping surface is in the bedroom and the sitting surface is down the hall in the bathroom and the patient is independent moving from the supine to sitting position, sitting to standing, and then standing to sitting, but requires minimal human assistance or an assistive device to ambulate from the bed to the sitting surface, the appropriate M1850 score would be a “1”. If the patient requires more than minimal assistance or requires both minimal human assistance and an assistive device, the appropriate score would be a “2”.

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November 1, 2011

2012 payment changes are finalized

The down and dirty: Payments to home health agencies (HHAs) are estimated to decrease by approximately 2.31 percent or $430 million in CY 2012, the net effect of a 1.4 percent payment update, the wage index update, and the case-mix coding adjustment. 

Hypertension has officially been removed from the case-mix list, payments have dropped for high-therapy episodes, and case-mix weights have been recalibrated.

The Affordable Care Act applies a 1 percentage point reduction to the 2012 home health market basket amount.  As the 2012 market basket is equal to 2.4 percent, the payment update for HHAs in 2012 will be 1.4 percent, according to the Center for Medicare and Medicaid Services. 

CMS also reduced HH PPS rates in 2012 to account for additional growth in aggregate case-mix that is unrelated to changes in patients’ health status.  CMS has finalized a 3.79 percent reduction to the home health PPS rates for 2012 and an additional 1.32 percent reduction for 2013.

The final rule is in the Federal Register. .   

CMS’s main HH PPS page is here.