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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.

Instructions for the Home Health PPS PC Pricer Program

For instructions on using the 2017 and later versions of the PC Pricer software, use the "HH PC Pricer Instructions - 2017 & Later" document located in the "Downloads" section.

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