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CMS Instructs MACs on Three Percent Rural Add-On Adjustment

Posted on Friday, March 23, 2018 7:10 PM

CMS has issued Change Request 10531, which provides instructions to the Medicare Administrative Contractors (MACs) to reprocess home health claims eligible for the three percent rural add-on pursuant to the Bipartisan Budget Act of 2018.  On February 9, 2018, Congress passed the Bipartisan Budget Act of 2018 which contains several provisions that extend certain Medicare Fee For Service (FFS) policies, including the 3% home health rural add-on payment for calendar year 2018.

The rural add-on applies to services the began or on April 1, 2010 and before January 1, 2019.  As a result, some Medicare home health claims will need to be reprocessed. 

The home health Pricer will be updated to allow for the three percent rural add-on on claims, effective April 2, 2018. Eligible claims with a “though” date on or after January 1, 2018 that were submitted prior the April 2 will be reprocessed to reflect the three percent add-on. According to CMS, the MAC will initiate the adjustments and agencies will not need to take any action.

Source: NAHC Report

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