Navigating the CMS Home Health Final Rule: A Q&A Session

The CMS Home Health Final Rule has introduced significant changes to the way home health agencies are reimbursed and regulated. It's crucial for home health providers to understand these changes and implement strategies to adapt and thrive in this evolving landscape. Read the top takeaways of the rule here. In our recent webinar, "The Home Health Final Rule Has Arrived: Learn the Essentials," we provided a comprehensive overview of the rule and its implications for home health agencies. Our expert presenters, Rob Simione, Principal, SVP, Consulting, and J'non Griffin, Principal, SVP, Coding, dissected the rule's key aspects and shared actionable strategies to help your agency navigate these changes successfully.

The webinar featured a Q&A session for audience members to seek clarity on specific aspects of the final rule, and we’ve compiled them here for you. We hope you find this blog helpful as you navigate the changes the Final Rule brings. If you have any questions, don’t hesitate to contact us.

CMS CY2024 Home Health Final Rule Questions


Where can I find CBSA?

CBSA are on the CMS website with the Wage Index changes.


What year cost report is CMS using for their 2024 Payment?

2022 Cost Reports were used.


Did you say that these OASIS changes will be pulled out when they do the calculation in 2025 for payment in 2027? And will that include VA payor?

It will include VA payor if it is a skilled patient.


Can you confirm the first performance year timeframe of the PPH?

The PPH first performance year timeframe is 2025.


Do we know if the compression garments and wraps will be included in consolidated billing under home health?

 They currently are not paid for by Medicare. Compression garments (standardized fitted garments) will be paid by Part B up to 3 compression garments a year. Include gradient pressure wraps for lymphedema treatment. Must have an order from a provider for treatment of lymphedema.

Therapists that furnish these items must become enrolled and accredited DMEPOS suppliers to bill for these items as lymphedema compression treatment items per section 1834(j)(5) of the Act or payment for the items applied during phase one of decongestive therapy would not be allowed.

We are currently collecting OASIS from all payors. However, we are questioning if we must do OASIS for skilled long-term care patients through the Office of Long-Term Living MCOs as it seems to not be necessary since they are long-term. Can you confirm if this is required?

 OASIS will only be required if you are providing skilled care to patients.


Base year change for VBP - is this a good thing or a bad thing for an underperforming agency?

Baseline for 2022-performance years 2023 and 2024; Baseline 2023 will be for 2025...Good or bad? Depends on how much you improve, and how much everyone else improves. Hard to say. The best advice is to use data to make targeted improvements where you can.


Covered in the Webinar

SimiTree’s CMS Home Health Final Rule webinar provided a detailed overview of the rule and discussed its implications for home health agencies. During the recorded on-demand one-hour session, attendees gained in-depth insights into what to expect from the CMS Home Health Final Rule. Our expert presenters, Rob Simione, Principal, SVP, Consulting, and J'non Griffin, Principal, SVP, Coding, dissected the rule's implications and shared strategies to help your agency not only adapt but thrive in this shifting environment.

Key Highlights We Covered:

  • Reimbursement Updates: We walked through the impact of CMS' permanent behavioral adjustments on Medicare PDGM base rates and what it means for your agency's bottom line.
  • Case Mix Recalibration: We explored the changes to case-mix components, including functional scoring and comorbidity adjustments, and how they affect your agency's reimbursement.
  • Value-Based Purchasing (VBP): We taught attendees about revisions to the Home Health VBP program, with a focus on "potentially preventable hospitalizations."
  • Quality of Care: We discussed key elements in discovering new requirements for quality reporting and performance improvement.
  • Preparing for Success: Shared practical tips on how to prepare for the changes outlined in the final rule, from operational improvements to diversifying your payor mix.
  • Expert Guidance: Our presenters, with their wealth of experience, provided valuable advice to ensure your agency is well-positioned for the future.


Did you miss this webinar and want to know about the next complimentary learning opportunity hosted by our experts?

Follow SimiTree on Facebook and LinkedIn where we share complimentary webinars like this one every month. Watch all of our webinars on YouTube, or visit our webinar page on our website to easily search through the topics. Add yourself to our email list by contacting us at contactus@simitreehc.com. Questions? Send us anything at questions@simitreehc.com.

How SimiTree Can Help

By attending our webinar and gaining in-depth knowledge of the CMS Home Health Final Rule, you have taken a crucial step toward preparing your agency for the future. By implementing the strategies discussed and adapting your operations to align with the new requirements, you can ensure that your agency continues to provide high-quality care while achieving financial stability and growth.

We encourage you to continue to stay informed about the ever-changing home health landscape and utilize resources like our webinars, case studies, informative blog posts, and expert consultations to navigate these changes effectively. Together, we can help your agency thrive in the face of regulatory changes and achieve sustainable success. Request a service or more information with this quick form fill.