CMS’ 2021 final PPS payment rule will increase payments to HHAs in aggregate by just 1.9%, or $390M.
That’s down from $530M, or a 2.7% increase, that was referenced in the proposed payment rule in June.
This may come as a shock to the industry that sought a bigger increase in Medicare payments in 2021 to account for the increased expenses and in some cases decreased revenue related to their COVID-19 response.
The rule also offers updated guidance on telehealth, finalizes a 5% cap on wage-index decreases and sets new policies for home infusion therapy.
According to the rule, agencies can use telecommunications technologies as long as any provision of remote patient monitoring or other services are included on the plan of care. CMS notes that the use of telecommunications or audio-only technology must be tied to the patient-specific needs as identified in the comprehensive assessment.
“CMS will not require a description of how such technology will help to achieve the goals outlined on the plan of care; rather documentation in the medical record should explain how such services will help facilitate treatment outcomes,” according to a CMS news release.
The use of technology may not substitute for an in-person home visit that is ordered on the plan of care and cannot be considered a visit for the purpose of patient eligibility or payment. An inability to bill for telehealth has been a sticking point for industry leaders.
CMS noted in its release that the rule expands the definition of telecommunications technology, in addition to remote patient monitoring, that HHAs are allowed to report as allowable administrative costs on the HHA cost report.
This rule also updates the home health wage index, including the adoption of revised OMB statistical area delineations and limiting any decreases in a geographic area’s wage index value to no more than 5% in CY2021.
This rule also finalizes a policy to align HHVBP Model data submission requirements with any exceptions or extensions granted for purposes of the HH QRP as well as a policy for granting exceptions to the New Measures data reporting requirements during the COVID-19 PHE, as described in the interim final rule related to the PHE.