New Home Health Data Reporting Rule Specifies Where Services are Provided

New data reporting requirements have been added to the Home Health Prospective Payment System (HH PPS) claims specifying where services are provided and if a physician has modified the plan of care, the Centers for Medicare & Medicaid Services (CMS) announced earlier this month. 

Home health agencies must report new codes indicating the location of where services were provided and must also detail whether services were added to the home health plan of care by a physician who did not certify the care plan, effective July 1, 2013, says CMS. 

Through the new requirements, Medicare wants to capture data showing where home health services are provided and when a physician, other than the certifying physician, adds or changes the plan or care to enable the Medicare to see how often additional orders are added to care plans. 


For home health episodes beginning on or after July 1, home health agencies are to use the HCPCS codes Q500, Q5002, and Q5009 on claims to report where services were provided—at a patient’s home or residence, in an assisted living community, or in a place not otherwise specified, respectively. 

If the location where services were provided changes during the episode, the new location should also be reported with an additional line corresponding to the first visit provided in the new location. 

In episodes where visits are added to the plan of care by a physician, Modifier XX must be appended to the HCPCS G code describing the visit. 


Read more here.

Written by Alyssa Gerace

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