Date: February 5, 2020
To: Enrolled Home Health Agencies and Home Nursing Agencies
Re: Rate Increase for Home Health Services
This notice informs providers of rate increases for specific home health services. These rates apply to services for participants covered under the Department’s fee-for-service program as well as those covered under a managed care plan.
Effective with dates of service beginning October 1, 2019, the Department’s maximum allowable rate increased from $72.00 to $111.00 for the following services: intermittent skilled nursing visits; home health aide visits; and physical, occupational, and speech therapy visits. These services are exempt from the 2.7% SMART Act rate reduction.
Effective with dates of service beginning November 1, 2019, the Department’s maximum allowable rates for in-home shift nursing for the Medically Fragile Technology Dependent waiver and nursing and personal care services for children 0-20 years of age increased as follows:
· Registered nurse services increased from $28.75 and $35.03 to $45.00.
· Licensed practical nurse services increased from $24.78 and $31.14 to $37.50.
· Certified Nurse’s Aide services increased from $20.00 to $25.00.
These services are exempt from the 2.7% SMART Act rate reduction.
Actual payment for covered services is based on the lesser of the provider’s charge or the maximum allowable rate established by the Department. As there was a Department delay in loading some of the updated intermittent skilled nursing, home health aide, and therapy visit rates, claims may have adjudicated prior to finalization of rate updates. The Department will identify those claims and systematically adjust the payments.
The Home Health Fee Schedule has been updated effective for both October 1, 2019 changes and November 1, 2019 changes. Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565.