CMS Changes Case Mix Weights Again in Proposed PPS Rules for 2015

Every case mix weight has changed in the CMS Proposed PPS Rules for 2015.  They have adjusted the rates to include the latest paid claims available as of 12/31/2013.  They have also reweighted some of the impact of therapy.  We encourage you to review all of the new case mix weights to determine the potential impact on you individual home health agency.  We have listed a sample below for your review.

Code	Therapy Utilization	C, F & S	2015 Case Mix Weight	2014 Case Mix Weight	Increase / (Decrease)	% Increase /(Decrease)
10111	1st and 2nd Episodes, 0 to 5 Therapy Visits	C1F1S1	0.5984	0.6080	-0.0096	-0.0158
10112	1st and 2nd Episodes, 6 Therapy Visits	C1F1S2	0.7250	0.7273	-0.0023	-0.0032
10113	1st and 2nd Episodes, 7 to 9 Therapy Visits	C1F1S3	0.8515	0.8468	0.0047	0.0056
10114	1st and 2nd Episodes, 10 Therapy Visits	C1F1S4	0.9781	0.9661	0.0120	0.0124
10115	1st and 2nd Episodes, 11 to 13 Therapy Visits	C1F1S5	1.1046	1.0856	0.0190	0.0175
21212	1st and 2nd Episodes, 16 to 17 Therapy Visits	C2F1S2	1.5241	1.5021	0.0220	0.0146
21213	1st and 2nd Episodes, 18 to 19 Therapy Visits	C2F1S3	1.7307	1.6558	0.0749	0.0452
22113	3rd+ Episodes, 18 to 19 Therapy Visits	C1F1S3	1.6296	1.5328	0.0968	0.0632
40111	All Episodes, 20+ Therapy Visits	C1F1S1	1.8217	1.6745	0.1472	0.0879

We will have much more on the proposed home health payment rules and rates for 2015 in future email alerts.  We have scheduled a Home Health Webinar titled “Understanding the Proposed Home Health PPS Rules & Rates for 2015” for July 31, 2014 from 3:00 pm to 4:30 pm EDT.  The webinar will be held Live, but will be available later on demand because it will be recorded.

The proposed rules were published in the federal register on July 7, 2014.  The link to the proposed rule is http://www.gpo.gov/fdsys/pkg/FR-2014-07-07/pdf/2014-15736.pdf