Humana has two approaches for reimbursing home health services for Medicare Advantage plans, episodes of care and per visit reimbursement. Episodes of care follow Original Medicare guidelines for reimbursement and are based on a 30-day period of care established by the Centers for Medicare & Medicaid Services’ (CMS) patient-driven groupings model (PDGM). Per-visit reimbursement is fee-for-service. Most commercial home health services contracts are based on per-visit reimbursement.
View the presentation, titled “Home Health Billing,” to learn more about Humana’s billing guidelines to ensure proper reimbursement for home health services rendered to patients with Medicare Advantage and commercial plans.
Access the “Home Health Billing” presentation, and many more, at Humana.com/MakingItEasier. Each feature in the series consists of an on-demand presentation addressing a specific topic along with a downloadable tip sheet.