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
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%)
|
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