Home Health Prospective Payment System (HH PPS) PC Pricer
The Balanced Budget Act (BBA) of 1997 (Public Law 105-33) required the creation of a prospective payment system for home health services. The Omnibus Consolidated and Emergency Supplemental Appropriations Act for 1999 (Public Law 105-277) established the effective date of the system, using dates of service on or after October 1, 2000. HH PPS applies to all home health services billed on type of bill 32x or 33x. The HH PPS Pricer makes all reimbursement calculations applicable under HH PPS, including percentage payments on requests for anticipated payments (RAPs), claim payments for full episodes of care, and all payment adjustments, including low utilization payment adjustments (LUPAs), partial episode payment (PEP) adjustments, significant change in condition(SCIC) adjustments and outlier payments.
User's Manual for the Home Health PPS PC Pricer Program - Detailed instructions for the use of the PC Pricer software, including field definitions, claims entry instructions and sample screens and reports. The User's Manual is located in the "Downloads" section.
Note: To be notified of changes or updates to the PRICER application, select the link for 'Receive Home Health PC Pricer Updates' in the Related Links Outside CMS section, see below, and subscribe to the HH-PPS-L listserv to receive automatic notices.
Downloads
- HH User's Manual [ZIP, 728KB]
- CY 2012 PC Pricer - Posted 08/17/2012 [ZIP, 2MB]
- CY 2012 Main Frame Pricer Software - Posted 01/31/2012 [ZIP, 401KB]
- FY 2011 - Posted 03/22/2012 [ZIP, 4MB]
- CY 2002 to 2007 Archive - Posted 01/31/2012 [ZIP, 6MB]
- FY 2008.4 - Updated 04/30/10 [ZIP, 1MB]
- FY 2009.4 - Updated 04/30/10 [ZIP, 1MB]
- FY 2010.A - Posted 07/30/2010 For claims from 01/01/2010 to 03/31/2010 [ZIP, 1MB]
- FY 2010.5 - Posted 05/05/2010 For claims from 04/01/2010 to 12/31/2010 [ZIP, 2MB]
- Page last Modified: 05/24/2012 7:29 AM
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