Home Health billing has specific differences from other types of services. There are physician certification requirements for ordering home health services.
The PDGM (Patient Driven Groupings Model) concept was developed effective in 2020 & this arrangement drives the correct reporting & reimbursement. HIPPS codes provide assessment of the patient’s ability to conduct certain activities (functional status) and the presence of any type of cognitive impairment to determine a payment group. HIPPS codes are required on all claims using revenue code 0023 on the UB 04.
We will review required documentation, completing the UB 04, & potential reimbursement changes for 2026
Webinar Objectives
- Understand the requirements for Home Health Billing
- Review required physician docmentation for ordering Home Health services.
- Understand the purpose of HIPPS codes
- Review how to calculate HIPPS codes
- Understand the PDGM concept
- Required documentation of services
Webinar Agenda
- Introduction to PDGM concept
- Review of Required HIPPS Codes
- Calculating the HIPPS Code for Revenue Code 0023
- Review of UB04 Revenue Codes
- Documentation Requirements
- Possible 2026 reimbursement changes
Webinar Highlights
- Introduction & review of HIPPS codes
- What is meant by PDGM concrept?
- Understanding the different categories in PDGM
- Complete documentation will be key to correct reimbursement
- Denial management
Who Should Attend
- Chargemaster Maintenance Staff
- Physicians
- Practice managers
- Medical assistants
- Nurses
- Compliance staff
- Billers
- Coders
- Revenue Cycle
- Risk Management
- Charge entry staff
- Home Health providers & staff
Dorothy Steed
Dorothy Steed (MSLD, CCS, CDIP, COC, CPCO, CPUM, CPUR, CPHM, CPMA, ACSOP, CCS-P, RCC, RMC, CEMC, CPC-I, CFPC, PCS, FCS, CRCR, CICA, CPAR) is an Independent Healthcare Consultant and Educator in Atlanta. She was a Medicare specialist for a large hospital system and a physician audit supervisor for another hospital system, with 44 years of experience in healthcare. Additionally, she is an instructor at a state technical college in Atlanta, provides auditing & training in both facility and physician services, and has been a speaker at several healthcare conferences. Ms. Steed has written articles for several medical publishers and served as a contributing author for medical...
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