42 C.F.R. § 484.235   Methodology used for the calculation of the partial episode payment adjustment.


Title 42 - Public Health


Title 42: Public Health
PART 484—HOME HEALTH SERVICES
Subpart E—Prospective Payment System for Home Health Agencies

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§ 484.235   Methodology used for the calculation of the partial episode payment adjustment.

(a) CMS makes a PEP adjustment to the original 60-day episode payment that is interrupted by an intervening event described in §484.205(d).

(b) The original 60-day episode payment is adjusted to reflect the length of time the beneficiary remained under the care of the original HHA based on the first billable visit date through and including the last billable visit date.

(c) The partial episode payment is calculated by determining the actual days served by the original HHA as a proportion of 60 multiplied by the initial 60-day episode payment.

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