Tuesday, July 8, 2014

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

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