The Centers for Medicare and Medicaid Services CMS released its final 2012 HHPPS regulation October 31, 2011. According to IHHC, 鈥淭he 2012 National Episode Rate will be a little higher than was proposed because CMS has decided to phase in the proposed 2012 case-mix creep reduction over two years. As a result, the case mix creep reduction for 2012 will be 3.79% with a 2013 reduction of 1.32%. With the market basket increase and other planned adjustments, the 2012 National Episode Rate will be $2,138.52, 2.4% than the 2011 rate of $2,192.07. Agencies that have failed to submit OASIS data and/or HHCAHPS data will experience a 2 percentage point decrease in the market basket increase of 1.4%.鈥�
CMS has adjusted its proposed reallocation of points from therapy to non-therapy episodes. According to Home Health Line, episodes with zero to five therapy visits will see a 3.75% increase, compared with the proposed 7.5%. Episodes with 14 or 15 visits will see a 2.5% reduction, compared with a 5% proposed reduction. And, episodes with 20 or more visits will see a 5% reduction, compared with the proposed 10%. Still, providers with a high percentage of therapy cases will see the most significant reductions in reimbursement in 2012.
CMS is also proceeding with its plan to reallocate point away from two hypertension codes: 401.1 (benign essential hypertension) and 401.9 (unspecified essential hypertension).
Finally, the proposed change in the face-to-face requirements to allow institutional physicians to hold the encounter and then report findings to the community physician who then certifies the patient for home health services has been adopted. 鈥�”
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