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CMS Manual System
CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 4228 Date: February 1, 2019 Change Request 11081 SUBJECT: Home Health (HH) Patient-Driven Groupings Model (PDGM) - Split Implementation I. SUMMARY OF CHANGES: This Change Request implements the policies of the HH PDGM as described in the November 2018 home health final rule. EFFECTIVE DATE: January 1, 2020 - Claim "From" dates on or after this date. *Unless otherwise specified, the effective date is the date of service. IMPLEMENTATION DATE: July 1, 2019 - for design and requirements; October 7, 2019 - for coding and testing including Beta HH Pricer; January 6, 2020 - for continued testing and implementation. To the extent feasible, tasks during the three releases may be worked using an Agile process.
Since October 2000, home health agencies (HHAs) are paid under a prospective payment system (HH PPS) for a 60-day episode of care that includes all covered home health services.
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