Medicare Issues 2021 Final Payment Rule

CMS finalized the CY 2021 Home Health PPS Rate Update, which also covers quality reporting requirements and new regulations for home infusion therapy. The rule is relatively unchanged from last year.

  • Base payment rates are increased by 2%.
  • The PDGM behavioral adjustment remains at 4.36%.
  • The national standard base rate for a 30-day period of care is $1,901.12.
  • Medicare home health spending is expected to increase by $390 million.
  • The rural add-on continues to phase out. Merrimack County receives no add-on; all other NH counties receive 1%.
  • There were no changes to the HH QRP for 2021.
  • OASIS-E is delayed for one full calendar year after the end of the COVID-19 Public Health Emergency, which means sometime in 2022 at the earliest.

Home infusion therapy (HIT) rules were clarified for 1/1/21. Agencies that want to continue to deliver Part B IV drugs must become a HIT supplier under Medicare Part B, or contract with an HIT supplier.