Coding and Billing Information

Home Health PPS Coding and Billing Information includes:

  • HH PPS HIPPS code weight table - See "Downloads" section below. These spreadsheets map each of the 1836 HIPPS code for the HH PPS to its associated case-mix weight.
  • Home Health PPS Grouper Software and Documentation - See "Related Links Inside CMS" below.
  • Health Insurance Prospective Payment System (HIPPS) Codes - See "Related Links Inside CMS" below.
  • Home Health PC Pricer - Program used by CMS to calculate Home Health Resource Group (HHRG) rates and all applicable adjustments. The link below also includes a user manual for the program. See "Related Links Inside CMS" below.
  • Home Health Consolidated Billing Master Code List - An Excel workbook file containing complete lists of all codes ever subject to consolidated billing provision of HH PPS. A master list worksheet shows the dates each code was included and excluded from consolidated billing editing on claims, with associated CMS transmittal references. The master list also associates each code with any related predecessor and successor codes. Supplemental worksheets show the list of included codes for each CMS transmittal to date. See "Downloads" section below.
  • Home Health PPS Wage Index Files - See "Downloads" section below.