Home Health Grouper Software
Home Health PDGM Grouper Software Package (for claims starting 01-01-2020)
In November 2018, CMS finalized a new case-mix classification model, the Patient-Driven Groupings Model (PDGM), effective beginning January 1, 2020. The PDGM 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.
The Home Health Patient-Driven Groupings Model (HH PDGM) Grouper software package, v01.0.20 is available for download. It is effective for home health claims with From Dates on or after January 1, 2020.
Included in the v01.0.20 software update are:
- HH PDGM grouping software package, version 01.0.20, in the zipped file named “HHPDGM.V01.0.20.R0.Software.P”
- HH PDGM Installation and User Manual is available in the ‘docs’ folder, once the software file is unzipped.
Installing the Home Health Grouper Software
The contents in the zip file should be unzipped into the following folder (keeping the existing directory structure intact):
*** IMPORTANT ***
If installed into any other directory than the one defined above, then the runGrouperHPtest.bat and configuration files in the following directory must be updated to reference the new location: \config
Support for the HH-PPS Grouper Software
For related questions, please use the following contacts:
- Email: CMS_IT_SERVICE_DESK@cms.hhs.gov or contact CMS IT Service Desk, phone 410-786-2580 or 1-800-562-1963: Contact for questions with HH-PPS Beta release notification or HH-PPS beta software download
- Email: CMSOASISquestions@oasisanswers.com: Contact for questions with OASIS
- Email: PCPricers@cms.hhs.gov: Contact for questions with Home Health PC Pricer
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 will be used to process Home Health claims.