Monday, July 16, 2012

Medicare Home Health PPS Rules and Rates for 2013 July 10


July 10 - Medicare Home Health PPS Rules and Rates for 2013
CMS has announced the publication of the Proposed PPS Rules and Rates for 2013. There are numerous changes included in this proposed rule. This update will include a summary of the Proposed Rates. We will follow up this email for the next few days with details on some of the areas.
  
More Detail on Proposed Medicare Home Health Payment Rates for 2013

Description
Proposed Rate
2013
Current Rate
2012

Increase
Percent
Increase
Urban Agency Base Rate*
$2,141.95
$2,138.52
$3.43
0.16%
Rural Agency Base Rate*
$2,206.21
$2,202.68
$3.53
0.16%
 *This must be adjusted by wage index and case mix
   
Urban LUPA Rates
Proposed
Rate 2013
Current
Rate 2012

Increase
Skilled Nursing (2)
$114.57
$112.88
$1.69
Physical Therapy (2)
$125.28
$123.43
$1.85
Occupational Therapy (2)
$126.12
$124.26
$1.86
Speech Pathology (2)
$136.13
$134.12
$2.01
Medical Social Services (2)
$183.67
$180.96
$2.71
Home Health Aide (2)
$51.90
$51.13
$0.77
LUPA Add On (2)
$96.04
$94.62
$1.42

Rural LUPA Rates
Proposed
Rate 2013
Current
Rate 2012

Increase
Skilled Nursing (2)
$118.01
$116.27
$1.74
Physical Therapy (2)
$129.04
$127.13
$1.91
Occupational Therapy (2)
$129.90
$127.99
$1.91
Speech Pathology (2)
$140.21
$138.14
$2.07
Medical Social Services (2)
$189.18
$186.39
$2.79
Home Health Aide (2)
$53.46
$52.66
$0.80
LUPA Add On (2)
$98.92
$97.46
$1.46
(2) These rates must be adjusted by wage Index 

Medical Supply Payment Rates
Urban Payment Severity Level
Points
(Scoring)
Relative
Weight
Proposed Rate 2013
Current
Rate 2012

Increase
1
0
0.2698
$14.59
$14.39
$0.20
2
1 to 14
0.9742
$52.68
$51.95
$0.73
3
15 to 27
2.6712
$144.46
$142.46
$2.00
4
28 to 48
3.9686
$214.62
$211.65
$2.97
5
49 to 98
6.1198
$330.96
$326.37
$4.59
6
99+
10.5254
$569.21
$561.32
$7.89

Please remember that all of the above payment rates will be reduced by 2 percent for home health agencies that do not submit quality data.

CMS also made a change to the labor and non-labor portion of payment rates:
Labor & Non Labor
Portion of Payment Rates

New 2013

Old 2012

Variance
Labor Portion
78.535%
77.082%
1.453%
Non Labor Portion
21.465%
22.918%
(1.453%)

No comments:

Post a Comment