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 |
0.5985
|
0.6080
|
(0.0095)
|
(1.56%)
|
| 10112 | 1st and 2nd Episodes, 6 Therapy Visits | C1F1S2 |
0.7242
|
0.7273
|
(0.0031)
|
(0.43%)
|
| 10113 | 1st and 2nd Episodes, 7 to 9 Therapy Visits | C1F1S3 |
0.8499
|
0.8468
|
0.0031
|
0.37%
|
| 10114 | 1st and 2nd Episodes, 10 Therapy Visits | C1F1S4 |
0.9756
|
0.9661
|
0.0095
|
0.98%
|
| 10115 | 1st and 2nd Episodes, 11 to 13 Therapy Visits | C1F1S5 |
1.1013
|
1.0856
|
0.0157
|
1.45%
|
| 21111 | 1st and 2nd Episodes, 14 to 15 Therapy Visits |
C1F1S1
|
1.2270
|
1.2049
|
0.0221
|
1.83%
|
| 21112 | 1st and 2nd Episodes, 16 to 17 Therapy Visits |
C1F1S2
|
1.4220
|
1.3615
|
0.0605
|
4.44%
|
| 21113 | 1st and 2nd Episodes, 18 to 19 Therapy Visits |
C1F1S3
|
1.6171
|
1.5180
|
0.0991
|
6.53%
|
| 40111 | All Episodes, 20+ Therapy Visits |
C1F1S1
|
1.8122
|
1.6745
|
0.1377
|
8.22%
|
We will have much more on the Final 2015 Home Health PPS Payment Rules and Rates in future email alerts. We have scheduled a Home Health Webinar titled "Final 2015 Home Health PPS Rules & Rates" for November 20, 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 final rule will be published in the Federal Register on November 6th. We will provide a new link at that time.
Registration Form
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