The Home Health Final Rule for 2023 was released on October 31, 2022. This Final Rule brings many changes that were in the proposed rule; however, there is disappointment with the behavioral adjustment that was originally proposed at a 7.8% reduction in our permanent 30-day base rate. They have decided to split that in half and are going to take 3.9% this year, and 3.9% in any future adjustments. Because they increased the market basket from the proposed 2.9% to 4.1% with a productivity reduction of .1%, this brings the market basket adjustment to 4%. The base rates will be decreased from $2,031.64 that we have today to $2,010.69 next year. That is dramatically higher than what was originally proposed, which was roughly $1,900.   

There is still activity going on in Congress with the two bills that have been introduced, one in the Senate and one in the House. The goal is to get those passed so that Home Health would see no reductions in payment through the year 2026. If that were to still take place, there should be room for making the change so that this 3.9% adjustment would not actually take effect in January. This could be retroactively corrected if the legislation does not pass before January, so as of right now, the base rate will be $2010.69.  

The LUPA (Low Utilization Payment Adjustment) per visit rates are not in any way impacted by the behavioral adjustment, so they received a 4% market basket increase. In addition to the rates, they finalized that Home Health agencies will be required to complete and submit OASIS on all patients, regardless of payer, but that will not be in effect until 2025, first affecting our Home Health quality reporting program outcomes in 2027.  

It has been finalized that there will be three new G codes to report on the various levels of Telehealth and remote patient monitoring on your claims. It will not impact payments; it is for information collection only. This will become voluntary in January and continue through the end of June. It will then be required to be implemented in July 2023. Any Telehealth or remote patient monitoring that you provide to the patient will need to be reflected on the claim even though it will not impact your payments. At this point, it will simply provide additional information to hopefully set future rates for Telehealth reimbursement.   

In addition to these changes, case-mix weights for each of the 432 HIPPS codes have been revised and finalized as they were proposed. The changes in the LUPA thresholds have also been finalized as they were originally proposed.   

Lastly, there was a proposal to change the baseline year for the Value-Based Purchasing model that is set to begin nationwide in January 2023. They have finalized that 2022 will be the baseline year.  They had originally said that 2019 would be used.  This means that achievement thresholds and benchmarks that will be used in the calculation of the 2023 outcomes will not be available until July 2023. That will give the system time to gather the 2022 data and calculate and analyze it. Then, the achievement thresholds and benchmarks based on the 2022 data will be issued.   

This was not the news that was hoped for, especially regarding the rates with this Final Rule, but we will continue to fight and to work with our legislators to hopefully get these rates dealt with and fixed so that Home Health will not see a reduction in rates through the year 2026. To help support that legislative fight, please make sure to participate and contact your legislators and let them know how we need this to be changed.  

If you need help with anything or have any questions, please feel free to contact us.