On Friday we published an
Email Blast about the Proposed Home Health PPS Rates for 2014. This is the second article about the Proposed
PPS Rates. Today we will list the actual
episode payment rates, LUPA payment rates and Non Routine Medical Supply
Rates. Look for more Email Blast this
week about the Proposed Home Health PPS Rules and Rates for 2014.
Base Urban Episode Rates Before Case Mix and Wage Index
Adjustments
|
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Description
|
2014
|
2013
|
Variance (*)
|
% Variance
|
Standard Episode Payment
Rate
|
$2,860.20
|
$2,137.73
|
$722.47
|
33.80%
|
(*) CMS increased the base
rate by 35.17% as part of standardizing the case mix rate. The 33.80% increase is really a decrease
because of the artificial increase of 35.17% in the base rate to account for
the 35.17% decrease in case mix rate.
Remember your episode case mix rates will be decreased by 35.17% so for
example C1F1 with 0 to 5 therapy visits will go from 0.8186 case mix rate in
2013 to 0.6056 in 2014.
LUPA Rates Urban Agencies Before Wage Index Adjustments
|
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Description
|
2014
|
2013
|
Variance
|
% Variance
|
Skilled Nursing
|
$121.23
|
$114.35
|
$6.88
|
6.02%
|
Physical Therapy
|
$132.56
|
$125.03
|
$7.53
|
6.02%
|
Occupational Therapy
|
$133.46
|
$125.88
|
$7.58
|
6.02%
|
Speech Pathology
|
$144.03
|
$135.86
|
$8.17
|
6.02%
|
Medical Social Work
|
$194.34
|
$183.31
|
$11.03
|
6.02%
|
Home Health Aide
|
$54.91
|
$51.79
|
$3.12
|
6.02%
|
Medicare has proposed a
change to the LUPA Add-On payments instead of a flat LUPA Add-On payment
Medicare will base the LUPA-Add On payment based on which discipline makes the
initial visit.
LUPA Add-On Payment Amounts Before Wage Index Adjustments
|
|||
Description
|
Base
2014
Rate
|
Add-On
Factor
|
Revised
Rate
1st Visit
|
Skilled Nurse makes
initial visit
|
$121.23
|
1.8714
|
$226.87
|
Physical Therapist makes
initial visit
|
$132.56
|
1.6841
|
$223.24
|
Speech Pathologist makes
initial visit
|
$144.03
|
1.6293
|
$234.67
|
Medicare has proposed a cut
of 2.4% for Non-Routine Medical Supplies 2014, 2015, 2016, and 2017.
Non-Routine Medical Supply Base Rate
|
|
Description
|
2013
Factor
|
2013 Rate
|
$53.97
|
2014 Rebasing adjustment
(x 0.9742)
|
$52.58
|
2014 HH Market Basket (x
1.024)
|
$53.84
|
Proposed 2014 Non-Routine Medical Supply
|
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Severity
|
Points
|
Relative Weight
|
Proposed NRS Payment Amount
|
1
|
0
|
0.2698
|
$14.53
|
2
|
1 to 14
|
0.9742
|
$52.45
|
3
|
15 to 27
|
2.6712
|
$143.82
|
4
|
28 to 48
|
3.9686
|
$213.67
|
5
|
49 to 98
|
6.1198
|
$329.49
|
6
|
99+
|
10.5254
|
$566.69
|
Remember that all rates
must be adjusted for urban and rural home health agencies. LUPA Rates and Episodes Rates must be
adjusted by wage index. Episode rates
must be adjusted by wage index and case mix.
Home health agencies that do not submit quality data will receive an
additional 2 percent cut in payments.
We sent a note out to home
health agencies last week titled “It is
Time to Step Up or Fall Behind”. We
stated that your home health agency is currently going up the down
escalator. The current momentum of the
health care industry is constantly pushing your company down, just like a down
escalator is constantly moving down. To
step up to the next star, you adapt and embrace the changes or place your head
in the sand and move further down the escalator.
If you would like to step
up instead of falling behind attend our Home
Health Leadership Conference on September
23rd to September 25th
at the Hilton Waikoloa Village on
the “Big Island” in Hawaii. We will cover the home health
proposed PPS Rule and methods to successfully adapt the changes.
For more information use
the temporary link below (The final link will be available on July 3rd
when proposed rule is published in the Federal Register):
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