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Home Health Prospective Payment System (HH PPS) PC Pricer

The Balanced Budget Act (BBA) of 1997 (Public Law 105-33) required the creation of a prospective payment system for home health services. The Omnibus Consolidated and Emergency Supplemental Appropriations Act for 1999 (Public Law 105-277) established the effective date of the system, using dates of service on or after October 1, 2000. HH PPS applies to all home health services billed on type of bill 32x or 33x. The HH PPS Pricer makes all reimbursement calculations applicable under HH PPS, including percentage payments on requests for anticipated payments (RAPs), claim payments for full episodes of care, and all payment adjustments, including low utilization payment adjustments (LUPAs), partial episode payment (PEP) adjustments, significant change in condition(SCIC) adjustments and outlier payments.

User's Manual for the Home Health PPS PC Pricer Program

Detailed instructions for the use of the PC Pricer software, including field definitions, claims entry instructions and sample screens and reports. The User's Manual is located in the "Downloads" section.

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