Home Health Agencies: CY 2021 Payment and Policy Changes and Home Infusion Therapy Benefit

On October 29, CMS issued a final rule that finalizes routine updates to the home health payment rates for Calendar Year (CY) 2021 in accordance with existing statutory and regulatory requirements. This rule also finalizes the regulatory changes related to the use of telecommunications technology in providing care under the Medicare home health benefit.

CMS estimates that Medicare payments to Home Health Agencies (HHAs) in CY 2021 will increase in the aggregate by 1.9 percent, or $390 million, based on the finalized policies. This increase reflects the effects of the 2.0 percent home health payment update percentage ($410 million increase) and a 0.1 percent decrease in payments due to reductions in the rural add-on percentages mandated by the Bipartisan Budget Act of 2018 for CY 2021 ($20 million decrease). This rule also updates the home health wage index including the adoption of revised Office of Management and Budget statistical area delineations and limiting any decreases in a geographic area’s wage index value to no more than 5 percent in CY 2021.

This final rule also:

  • Finalizes Medicare enrollment policies for qualified home infusion therapy suppliers
  • Updates the home infusion therapy services payment rates for CY 2021
  • Finalizes a policy excluding home infusion therapy services from home health services as required by law
  • Finalizes policies under the Home Health Value Based Purchasing Model published in the interim final rule with comment period, as required by law

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