FFS HHCCN

What's New

12/03/2024: The Office of Management and Budget (OMB) has approved the Home Health Change of Care Notice (HHCCN) for 3 years.  There were no substantive changes made to the HHCCN form or the form instructions. CMS did make plain language and information design changes to the form and form instructions according to our Office of Communications (OC) recommendations.  OC’s recommendations in plain language and information design are research-based best practices. The OC worked to apply the same research-based standards across all products and channels to make sure our language, messaging and branding are consistent. CMS has also provided the HHCCN in 3 additional languages with this package approval.  Those languages, along with English and Spanish, include Chinese, Vietnamese and Korean.  

Since the current HHCCN does not expire until 12/31/2024, you may continue to use the HHCCN (OMB expiration date of 12/31/2024) until 1/31/2025 however, you will be required to use the newly approved HHCCN (OMB expiration date of 11/30/2027) on 2/1/2025.  The newly OMB approved HHCCN form (expiration date of 11/30/2027) may be found in the downloads section. 

Home health agencies (HHAs) are responsible for issuing the following beneficiary rights and protections notices to Original Medicare (fee for service - FFS) beneficiaries when notice is required:

•   Home Health Change of Care Notice (HHCCN) (ZIP)
•   Advance Beneficiary Notice of Noncoverage (ABN)
•   Notice of Medicare  Non-coverage (NOMNC)
•   Detailed Explanation of Non-coverage (DENC)

The HHCCN, Form CMS-10280, is used to notify Original Medicare beneficiaries receiving home health care benefits of plan of care changes.  HHAs are required to provide written notification to beneficiaries before reducing or terminating an item and/or service. 

To download the HHCCN and its corresponding instructions (found in the Medicare Claims Processing Manual, 100-4, Chapter 30), please click on the links below under "Downloads".

Questions?

Questions regarding the HHCCN, ABN, NOMNC and DENC can be submitted at: https://appeals.lmi.org