CMS-1747-F

Description

On November 2, 2021, The Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1747-F) that updates the Medicare Home Health Prospective Payment System (HH PPS) rates and wage index for calendar year (CY) 2022. CMS estimates that Medicare payments to HHAs in CY 2022 would increase in the aggregate by $570 million (3.2 percent). The $570 million increase in estimated payments for CY 2022 reflects the effects of the CY 2022 home health payment update percentage of 2.6 percent ($465 million increase), an estimated 0.7 percent increase that reflects the effects of the updated fixed-dollar loss (FDL) ratio ($125 million increase) and an estimated 0.1 percent decrease in payments due to the changes in the rural add-on percentages for CY 2022 ($20 million decrease).

This final rule finalizes the recalibration of the PDGM case-mix weights, functional levels, and comorbidity adjustment subgroups while maintaining the CY 2021 LUPA thresholds for CY 2022 and updates the FDL. Finally, this rule finalizes the policy to utilize the physical therapy (PT) LUPA add-on factor as a proxy until we have CY 2022 data to establish the OT add-on factor for the LUPA add-on payment amounts. 

A Home Health Claims-OASIS Limited Data Set (LDS) file will be made available, upon request, to accompany the CY 2022 HH PPS proposed rule. Please visit the Home Health Prospective Payment System (HH PPS) Limited Data Set (LDS) webpage for more information.