The home health PEPPER report undergoes updates annually in the month of July. The latest update followed the usual pattern, although it was delayed by a few weeks compared to its initial distribution date. However, it has now been released and is accessible on the PEPPER site. To obtain the PEPPER information, please click here. 

PEPPER, or the Program for Evaluating Payment Patterns Electronic Report, is a comprehensive collection of data derived solely from your 30-day final claims. It is not affected by your cost report, care plans, or OASIS data. The PEPPER data is compiled and used to calculate targets. These targets are then compared to the 80th percentile benchmarks of the nation, your Medicare MACs jurisdiction, and your state. If your target calculations exceed the 80th percentile benchmark of the nation, your data may be flagged for potential additional medical review. 

Numerous home health and hospice organizations have faced increased medical review due to findings in their PEPPER reports. It is crucial for your compliance, QA team, and medical review team to have access to the PEPPER data to identify areas that require focused QA efforts. Specifically, targets exceeding the 70th percentile should be carefully reviewed to ensure you are progressing in the right direction. This means taking steps to avoid surpassing the 80th percentile in future calculations, thereby maintaining compliance. 

We are here to support you. We have successfully guided multiple organizations in reviewing their PEPPER data and helping them identify areas of focus. If you have any further inquiries or require assistance with your PEPPER, please do not hesitate to reach out to us.

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The CHAP Verified HPS Clinical Compliance Consulting team is able to provide comprehensive support and guidance when you need it most. Learn more about our CHAP Certified Consultants here.