Update on HIPPS codes on MA plan Claims
June 24, 2013 08:41 AM
In a conference call with CMS officials earlier this week, NAHC learned that although the MA plans have been instructed to include a HIPPS codes on claims effective July 1, 2013, the edits for this requirement will not be turned on until sometime in September. CMS will get back to NAHC with a firm date as to when exactly. At least for the short term there will be no payment consequence for MA plans that do not submit a HIPPS code for home health services, and therefore home health claims should not be held up either.
CMS expects the HIPPS code to be entered on claims the same as with Fee for Service Medicare. We do urge the providers and their vendors to begin the necessary changes to their software systems to be ready for when the firm compliance date is announced. We also urge you to contact your health plans to determine what specifically they are, or are not, requiring related to including the HIPPS code on claims.
We are seeking feedback on whether agencies and vendors can alter their systems in time for September.