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Notice to Home Health Billing Staff on Rural Add-On Payment Code Effective January 1, 2019

Home health rural add-on payments will now vary based on the county in which the service was furnished. Medicare requested the National Uniform Billing Committee create a new code to meet this requirement. The new value code 85 is effective on January 1, 2019 and is defined as “County Where Service is Rendered.” A county-based rural add-on is applied to the national, standardized episode rate, national per-visit payment rates, Low Utilization Payment Adjustment (LUPA) add-on payments, and the Non-Routine Supplies (NRS) conversion factor when home health services are provided in rural (non-Core Based Statistical Area (CBSA)) areas for episodes and visits ending on or after January 1, 2019 and before January 1, 2023.

Summary of this Medicare update

Official instruction, CR 10782, issued to your MAC regarding this change

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