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August Humana News: Discover more about Humana's updated billing guidelines for home health services

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08/27/2021

Discover more about Humana’s updated billing guidelines for home health services

There are two primary approaches to reimbursement for home health services rendered to patients with MA coverage:

  • Episodes of care: Per Original Medicare, reimbursement is based on a 30-day period of care established by the CMS patient-driven groupings model (PDGM)  
  • Per visit: Reimbursement is fee-for-service based. 

Most contracts for home health services for patients with Humana commercial plans are based on per-visit reimbursement methods. Healthcare providers must bill according to contract requirements. If contracted according to Medicare reimbursement methodology, bill according to Humana Medicare MA billing guidelines previously addressed. If not contracted for Medicare, bill according to the requirements outlined in the contract.  

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 and includes a downloadable tip sheet.