CMS Releases Home Health Utilization & Payment Data

December 22, 2016
Rick Gawenda

The Centers for Medicare and Medicaid Services (CMS) has posted the 2014 Home Health Agency Public Use File for calendar year 2014. This file contains information on utilization, payment (Medicare payment and standard payment), submitted charges, and demographic and chronic condition indicators organized by CMS Certification Number (6-digit provider identification number), Home Health Resource Group (HHRG), and state of service.

The information presented in this file does not indicate the quality of care provided by individual home health agencies. The file only contains cost and utilization information. Additionally, the data are not risk adjusted and thus do not account for differences in the underlying severity of disease of patient populations treated by providers.

To access the data, click HERE.

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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

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  1. I’m a private practice PT in a rural area with a local hospital and a medicare certified home care agency that only does nursing visits. The hospital doesn’t even allow their PTs to do home visits anymore for insurance reasons. I’ve worked for 4 home care agencies in my past and am willing to do some home visits if needed. Do I need to do any extra certification or anything to do this??

    1. PTs can be employed by Home Health Agencies to provide PT in the home. No additional certification or training is required from a PT perspective.

  2. I am very new to Home Health and I am getting a great deal of information from all sides regarding what can and can’t be done. It is difficult to sort it all out. Some of what I am being told is as follows- I would appreciate any feedback to set the record straight on these items:

    1) Is there any regulation that mandates a certain # of minutes between treatment sessions? I have been told it is 15 minutes, but this doesn’t make sense to me. I had 5 patients in an assisted living facility that literally at times I walked across the hall and started the next treatment. Is this true?

    2) Is there any reg that sets minimum treatment time per session?

    3) Does documentation time get added to the treatment time for the purposes of calculating the time?

    4) Are there any guidelines that say there is a limit to the # of treatments that can be performed in a day