Home Health PPS Grouper Software (HHGS)

Home Health PPS Grouper Software (HHGS) Package (for claims starting 01-01-2024)

The January 2024 release of the HH PPS Grouper software (v05.0.24) is now available in the “Downloads” section of this webpage. A summary of the changes for what is included in the v05.0.24 HH PPS Grouper software update is listed below.

In November 2018, CMS finalized a case-mix classification model, the Patient-Driven Groupings Model (PDGM), effective beginning January 1, 2020. The PDGM, or Home Health PPS Grouper Software (HHGS), relies more heavily on clinical characteristics and other patient information to place home health periods of care into meaningful payment categories and eliminates the use of therapy service thresholds. In conjunction with the implementation of the PDGM, there will be a change in the unit of home health payment from a 60-day episode to a 30-day period.

The following reflect changes in the v05.0.24 software update:

• There are no software logic or interface changes for v05.0.24.

The following tables impacting grouping logic and HIPPS code assignments are updated effective January 1, 2024. Refer to the Summary of Data Changes document accompanying the software to review the details related to table changes:

• Updated thresholds values for functional impairment levels for all clinical groups. 
• Updated the functional impairment scoring for OASIS elements. 
• Updated the list of comorbidity subgroups applicable for low comorbidity adjustment. 
• Updated the comorbidity subgroup interactions list applicable for high comorbidity adjustment.

Support for the HH-PPS Grouper Software

For related questions, please use the following contacts:

• Email: HHGrouperQuestions@cms.hhs.gov: Contact for questions with HH PPS Grouper

Home Health PPS Grouper Software Package (for claims through 12-31-2019)

Archived versions of the Home Health Prospective Payment System (HH PPS) Grouper are available for download. The HH PPS Grouper software will only work for OASIS submissions with an assessment completion date from through December 31, 2019. Effective January 1, 2020 the Home Health Patient Driven Grouping Model, or revised Home Health PPS Grouper Software (HHGS), will be used to process Home Health claims.