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The following text is the complete Chapter 7, Home Health Services, of the Medicare Benefit Policy Manual. This version was retrieved on 31 May 2016. Always verify you have the most recent information from https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c07.pdf.
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Medicare Benefit Policy Manual: Chapter 7 - Home Health Services
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Transmittals for Chapter 7
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10 - Home Health Prospective Payment System (HH PPS)
10.1 - National 60-Day Episode Rate
10.2 - Adjustments to the 60-Day Episode Rates
10.3 - Continuous 60-Day Episode Recertification
10.4 - Counting 60-Day Episodes
10.5 - Split Percentage Payment Approach to the 60-Day Episode
10.6 - Physician Signature Requirements for the Split Percentage Payments
10.7 - Low Utilization Payment Adjustment (LUPA)
10.8 - Partial Episode Payment (PEP) Adjustment
10.9 - Outlier Payments
10.10 - Discharge Issues
10.11 - Consolidated Billing
10.12 - Change of Ownership Relationship to Episodes Under PPS
20 - Conditions To Be Met for Coverage of Home Health Services
20.1 - Reasonable and Necessary Services
20.2 - Impact of Other Available Caregivers and Other Available Coverage on Medicare Coverage of Home Health Services
20.3 - Use of Utilization Screens and “Rules of Thumb”
30 - Conditions Patient Must Meet to Qualify for Coverage of Home Health Services
30.3 - Under the Care of a Physician
30.4 - Needs Skilled Nursing Care on an Intermittent Basis (Other than Solely Venipuncture for the Purposes of Obtaining a Blood Sample), Physical Therapy, Speech-Language Pathology Services, or Has Continued Need for Occupational Therapy
30.5 - Physician Certification and Recertification of Patient Eligibility for Medicare Home Health Services
30.5.1 - Physician Certification
30.5.2 - Physician Recertification
30.5.3 - Who May Sign the Certification or Recertification
30.5.4 - Physician Billing for Certification and Recertification
40 - Covered Services Under a Qualifying Home Health Plan of Care