Home Health PPS Grouper Software (HHGS)

Home Health PPS Grouper Software (HHGS) Package (for claims starting 1-01-2023)

The January 2023 release of the HH PPS Grouper software (v04.0.23) is now available in the “Downloads” section of this webpage. A summary of the changes for what is included in the v04.0.23 HH PPS Grouper software update is listed below. 

In November 2018, CMS finalized a 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, the unit of home health payment changed from a 60-day episode to a 30-day period.

Included in the v04.0.23 software update are:

  • Updated thresholds values for functional impairment levels for all clinical groups.
  • Updated the functional impairment scoring for OASIS elements.
  • Updated the clinical group assignment(s) for diagnosis codes; these updates also include the removal of clinical groups for some unspecified codes as designated by CMS.
  • Updated the comorbidity subgroup assignment(s) for applicable diagnosis codes.
  • Updated the list of comorbidity subgroups applicable for low comorbidity adjustment.
  • Updated the comorbidity subgroup interactions list applicable for high comorbidity adjustment.

Support for the HH-PPS Grouper Software

For questions about the HH-PPS Grouper please view the Home Health PC Grouper FAQs (PDF) document or send your inquiries to HHGrouperQuestions@cms.hhs.gov.

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.

Page Last Modified:
11/01/2022 11:03 AM