CMS Publishes Final PPS Rules and Rates for Home Health Agencies

CMS published the final Home Health Prospective Payment Rates for 2013 on November 8, 2012. They made some small changes from the proposed rules including reducing the inflation rate from 1.5% to 1.3%. The also changed the Fixed Dollar Loss Ratio from .67 to .45 to increase the Medicare Outlier payment to 2.5%.  The most detailed change relates to the survey and certification areas. Please carefully read this section of the final rules.

Listed below are the basic revised payment rates:

Description	Final Urban Episode Base Rate For 2013	Final Rural Episode Base Rate For 2013
Base Payment Rates (1)	$2,137.73	$2,201.86

(1)     This must be adjusted by wage index and case mix

LUPA Rates	Urban LUPA Base Rate	Rural LUPA Base Rate
Skilled Nursing (2)	$114.35	$117.78
Physical Therapy (2)	$125.03	$128.78
Occupational Therapy (2)	$125.88	$129.66
Speech Pathology (2)	$135.86	$139.94
Medical Social Services (2)	$183.31	$188.81
Home Health Aide (2)	$51.79	$53.34
LUPA Add On (2)	$95.85	$98.73

(2)     This must be adjusted by wage index

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%)

Listed below is the link for the final rule. 

http://www.gpo.gov/fdsys/pkg/FR-2012-11-08/pdf/2012-26904.pdf  

If you have questions or need additional information please call Richard Dixon at (321) 473-8561.