A new version of the “Expanded HHVBP Model Frequently Asked Questions (FAQs)” has been released, with new responses on questions about how OASIS-E impacts HHVBP.
 
The new responses also address the billing process for HHVBP:
 
Under the expanded HHVBP Model, payment adjustments (Adjusted Payment Percentage, or APP) are the amount by which a competing HHA's final claim payment amount under the HH PPS is changed in accordance with the methodology described in §484.370. Under the expanded Model, CY 2023 will be the first performance year and CY 2025 will be the first payment year. CMS will apply a payment adjustment of a maximum of 5% upward or downward in CY 2025 based on an HHA's performance in CY 2023.
 
Once CMS calculates the APP for HHAs eligible for a payment adjustment, the process is as follows for Home Health Prospective Payment System (HH PPS) claims for Medicare FFS beneficiaries:
  1. The HHA submits a final claim as usual. There is no change in this process.
  2. The Medicare claims processing system reviews the claim, calculates payment, and applies the APP to the claim.
  3. The Medicare Administrative Contractor (MAC) pays the claims and returns the remittance advice with the claim. Please note, the adjustment amount is not separately identified on the remittance advice.