Home Health PPS Grouper Software (HHGS)
Home Health PPS Grouper Software (HHGS) Package (for claims starting 01-01-2021)
The January 2021 release of the HH PPS Grouper software (v02.1.21) is now available in the “Downloads” section of this webpage. Included in the v02.1.21 HH PPS Grouper software update are the FY 2021 International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes, effective beginning January 1, 2021
In November 2018, CMS finalized a new case-mix classification model, the Patient-Driven Groupings Model (PDGM), effective beginning January 1, 2020. The PDGM, or Home Health PPS Grouper Software (HHGS), relies more heavily on clinical characteristics and other patient information to place home health periods of care into meaningful payment categories and eliminates the use of therapy service thresholds. In conjunction with the implementation of the PDGM, there will be a change in the unit of home health payment from a 60-day episode to a 30-day period.
Included in the v02.1.21 software update are:
- Added 6 new ICD-10-CM diagnosis codes effective January 1, 2021, with Clinical Group and Comorbidity Sub-group assignments for applicable codes.
- Deleted 1 ICD-10-CM diagnosis code effective January 1, 2021.
Support for the HH-PPS Grouper Software
For related questions, please use the following contacts:
- Email: HHGrouperQuestions@cms.hhs.gov: Contact for questions with HH PPS Grouper
Note: Please do not submit Protected Health Information through this email system. It is not necessary to send personally identifiable data to demonstrate your question or concern.
Home Health PPS Grouper Software Package (for claims through 12-31-2019)
Archived versions of the Home Health Prospective Payment System (HH PPS) Grouper are available for download. The HH PPS Grouper software will only work for OASIS submissions with an assessment completion date from through December 31, 2019. Effective January 1, 2020 the Home Health Patient Driven Grouping Model, or revised Home Health PPS Grouper Software (HHGS), will be used to process Home Health claims.