evekhm/cms_iom_500 huggingface dataset:
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 Hemoglobin or hematocrit;   Blood sugar;   Examination of stool specimens for occult blood;   Pregnancy tests; and    Primary culturing for transmittal to a certified laboratory (No CPT code available).   RHCs/FQHCs bill all laboratory services to their MAC under the host providers bill type and payment is made under the fee schedule.  HCPCS codes are required for lab services.   Venipuncture is included in the AIR and the PPS per diem payment and is not separately billable.   Refer to Chapter 16 for general billing instructions.   Durable Medical Equipment (DME), ambulance services, hospital-based services, group services, and non- face-to-face services are also non -covered and are billed separately.   When billing these services on FQHC PPS claims, a FQHC payment code and qualifying visit HCPCS code is not  required.  100 - Frequency of Billing and Same Day Billing  (Rev. 3434, Issued: 12- 31-15, Effective: 03-31-16, Implementation: 03-31-16)  RHC and FQHC claims cannot overlap calendar years.  Therefore, the statement dates, or from and through dates of the claim, must always be in the same calendar year.   RHCs and FQHCs billing under the FQHC PPS may submit claims that span multiple days of service.  FQHCs billing under the PPS must submit all services that are rendered on the same day on one claim.  General information on basic Medicare claims processing can be found in this manual in:  Chapter 1, General Billing Requirements, (http://www.cms.hhs.gov/manuals/downloads/clm104c01.pdf) for general claims processing information;   Chapter 2, Admission and Registration Requirements, (http://www.cms.hhs.gov/manuals/downloads/clm104c02.pdf) for general filing requirements applicable to all providers.  For Medicare institutional claims:   See the Medicare Claims Processing Manual on the CMS website for general Medicare institutional claims processing requirements, such as for timely filing and payment, admission processing, and Medicare Summary Notices.   Contact your MAC for basic training and orientation material if needed.
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See the Medicare Claims Processing Manual on the CMS website for general Medicare institutional claims processing requirements, such as for timely filing and payment, admission processing, and Medicare Summary Notices.   Contact your MAC for basic training and orientation material if needed.  Transmittals Issued for this Chapter  Rev #  Issue Date  Subject  Impl Date  CR#  R12070CP   06/07/2023 Internet Only M anual Update to Publication 100-04, Chapters 9 and 18 to Clarify Vaccine Payment Instructions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)  07/10/2023 13218 R11200CP 01/12/2022 Implementation of the GV Modifier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) for Billing Hospice Attendin g Physician Services  01/03/2022    12357 R11095CP  10/29/2021 Implementation of the GV Modifier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) for Billing Hospice Attending Physician Services  - Rescinded and replaced by Transmittal 11200 01/03/2022 12357 R11029CP 09/29/2021 Implementation of the GV Modifier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) for Billing Hospice Attending Physician Services  - Rescinded and replaced by Transmittal 11095 01/03/2022 12357 R10907CP 08/10/2021 Implementation of the GV Modifier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) for Billing Hospice Attending Physician Services  - Rescinded and replaced by Transmittal 11029 01/03/2022 12357 R10357CP 09/18/2020 Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Chapter 9, Section 70.7 and 70.8. 10/19/2020 11961 R3434CP
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09/18/2020 Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Chapter 9, Section 70.7 and 70.8. 10/19/2020 11961 R3434CP 12/31/2015 Reorganization of Chapter 9 03/31/2016 9397 R3000CP  07/25/2014 Update to Pub. 100-04, Chapter 09 to Provide Language-Only Changes for Updating ASC X12 08/25/2014 8670 R2186CP  03/28/2011 Waiver of Coinsurance and Deductible for Preventive Services in Rural Health Clinics (RHCs), Section 4104 of Affordable Care Act (ACA)  04/04/2011 7208 R2122CP 12/21/2010 Waiver of Coinsurance and Deductible for Preventive Services in Rural Health Clinics (RHCs), Section 4104 of Affordable Care Act (ACA)  Rescinded and replaced by Transmittal 2186 04/04/2011 7208 R2093CP 11/12/2010 Waiver of Coinsurance and  Deductible for Preventive Services in Rural Health Clinics (RHCs), Section 4104 of Affordable Care Act (ACA)  Rescinded and replaced by Transmittal 2122 04/04/2011 7208 R2034CP 08/24/2010 Affordable Care Act (ACA) Mandated Collection of Federally Qualified Health Center (FQHC) Data and Updates to Preventive Services Provided by FQHCs 01/03/2011 7038 R2013CP 07/30/2010 Affordable Care Act (ACA) Mandated Collection of Federally Qualified Health Center (FQHC) Data and Updates to Preventive Services Provided by FQHCs - Rescinded and replaced by Transmittal 2034 01/03/2011 7038 R1843CP 10/30/2009 Outpatient Mental Health Treatment Limitation  01/04/2010 6686 R1719CP 04/24/2009 Rural Health Clinic  (RHC) and Federally Qualified Health Clinic (FQHC) Updates  10/05/2009 6445 R1707CP 03/27/2009 Assignment of Initial Enrollment FQHCS, ESRD Facilit ies, and RHCs 04/27/2009 6207 R1472CP
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03/27/2009 Assignment of Initial Enrollment FQHCS, ESRD Facilit ies, and RHCs 04/27/2009 6207 R1472CP 03/06/2008 Update of Institutional Claims References  04/07/2008 5893 R1426CP 02/01/2008 Announcement of Medicare Rural Health Clinics (RHCs) and Federally 02/12/2008 5896 Qualified Health Centers (FQHCs) Payment Rate Increases  R1421CP  01/25/2008 Update of Institutional Claims References - Rescinded and Replaced by Transmittal 1472 04/07/2008 5893 R1255CP 05/25/2007 Guidelines for Payment of Diabetes Self-Management Training DSMT) 07/02/2007 5433 R1158CP 01/19/2007 Guidelines for Payment of Diabetes Self-Management Training DSMT)  Replaced by Transmittal 1255 07/02/2007 5433 R820CP 02/01/2006 Sites of Service Revenue Codes for Rural Health Clinics and Federally Qualified Health Centers  07/03/2006 4210 R794CP 12/29/2005 Announcement of Medicare Supplemental Payments to Federally Qualified Health Centers Under Contract with Medicare Advantage Plan  04/03/2006 3886 R773CP 12/02/2005 Announcement of the Medicare Federally Qualified Health Center Supplemental Payment 04/03/2006 3886 R771CP 12/02/2005 Revisions to Pub. 100- 04, Medicare Claims in Preparation for the National Provider Identifier (NPI)  01/03/2006 4181 R371CP 11/19/2004 Updated Billing Instructions for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)  04/04/2005 3487 R167CP 04/30/2004 Discontinued Use of Revenue Code 0910 10/04/2004 3194 R001CP 10/01/2003 Initial Publication of Manual NA NA Back to top of Chapter
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Medicare Claims Processing Manual Chapter 9 - Rural Health Clinics / Federally Qualified Health Centers Crosswalk  New Chap New  Sect Int. Pub 13-3 Carrier Pub 14-3 RHC Pub. 27 Program Memo Description 9 10 A3-3642    General Differences Between RHCs and FQHCs  9 10 A3-3643    General Differences Between RHCs and FQHCs  9 10.1 A3-3642B B3-9200   Rural Health Clinics (RHCs) 9 10.2 A3-3643  RHC-400B  Federally Qualified Health Centers  9 10.3 A3-3642 B3-9200.1   Claims Processing Jurisdiction for RHCs and Federally Qualified Health Centers (FQHCs)  9 20 A3-3642  RHC-500  Method of Medicare Payment for RHCs and Federally Qualified Health Center (FQHC) Services 9 20 A3-3643  RHC-504  Method of Medicare Payment for RHCs and Federally Qualified Health Center (FQHC) Services 9 20.1 A3-3642B    Payment Rate for Independent and Provider Based RHCs and FQHCs 9      20.2 RHC-500 A-99-10 Calculation of the Encounter "Per Visit" Rate  9 20.3   RHC-500  Calculation of Payment 9 20.4   RHC-500  Determination of Payment New Chap New  Sect Int. Pub 13-3 Carrier Pub 14-3 RHC Pub. 27 Program Memo Description 9
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20.5 RHC-500 Annual Reconciliation9 20.6   RHC-505  Maximum Payment Per Visit 9 20.6.1    A-99-08 Rural Health Clinics 9 20.6.1    A-00-30 Rural Health Clinics 9 20.6.2   RHC-500  Federally Qualified Health Centers  9 20.6.3   RHC-505  Exceptions to Maximum Payment Limit (Cap) in Encounter Payment Rate for Provider-Based RHCs 9 20.7   RHC-505.3  Special Rules for FQHC Networks  9 20.7.1   RHC-505.3A  Separate Payment Limits for Individual Cost Reports 9 20.7.2   RHC-505.3B  Consolidated Payment Limit For Networks Having Mixture of Urban and Rural Sites 9 20.7.3   RHC-505.3C  Consolidated Payment Limit for FQHC Networks With All Urban or All Rural Sites 9 30   RHC-506  Annual Reconciliation with Cost Report 9 30.1   RHC-506  Submission of Cost Report  9 30.2 RHC-506.1 Payment Reconciliation9 30.3   RHC-506.2  Notice of Program Reimbursement 9 30.4   RHC-506.3  Recovery of Overpayments New Chap New  Sect Int. Pub 13-3 Carrier Pub 14-3 RHC Pub. 27 Program Memo Description 9 30.5   RHC-507  Reporting Requirements for Cost Report 9
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30.5.1 RHC-507B Definitions9 30.6   RHC-508  When to Submit Cost Reports 9 30.7   RHC-508C  Penalty for Failure to File Cost Reports Timely 9 30.8   RHC-508D  Consolidated Cost Reports 9 40   RHC-501  Allowable Costs  9 40.1   RHC-501.1  Costs Excluded from Allowable Costs 9 40.2   RHC-502  Allowable Costs Subject to Tests of Reasonableness 9 40.3 RHC-503 Screening Guidelines  of RHC/FQHC Health Care Staff Productivity 9 40.4 A3-3628  RHC-504  All Inclusive Rate of Payment 9 40.5 RHC-504.1A Bad Debts9 40.6   RHC-500B  Calculation of Medicare Program Payment 9 40.7   RHC-500C  Determination of Payments 9 50   RHC-504.1  Deductible and Coinsurance 9 50.1   RHC-500B  Part B Deductible 9 50.2   RHC-500B  Part B Coinsurance  New Chap New  Sect Int. Pub 13-3 Carrier Pub 14-3 RHC Pub. 27 Program Memo Description 9 60 A3-3185  RHC-612  Mental Health Services Limit  9 60.1   RHC-419.2E  Definition of Mental Health Services in RHC/FQHC 9 60.2 A3-3185.1  RHC-613  Application of Limit 9 70   RHC-608  Determining How Much to Charge Patient Before Billing Is Submitted for Part B Payment 9 100   RHC-620  General Billing Requirements 9 110   RHC-621  Reporting of Preventive Services by Independent FQHCs 9 120   RHC-614  Billing Requirements for Pneumococcal Pneumonia, Influenza Virus, and Hepatitis B Vaccines 9 130    A-99-8 Laboratory Services  9 140  B3-9204D   Intermediary/Carrier Coordination  9 140.1  B3-9204D   Intermediary Responsibility for Notifying Carrier 9 140.2  B3-9204   Special Carrier Actions Relating to RHCs/FQHCs  9 200   RHC-310  Agreements Between CMS and RHC/FQHC 9       200.1 RHC-310 General9 200.2   RHC-311  Duration of RHC/FQHC Agreement 9 200.3   RHC-313  Appeals by Entities
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Agreements Between CMS and RHC/FQHC 9       200.1 RHC-310 General9 200.2   RHC-311  Duration of RHC/FQHC Agreement 9 200.3   RHC-313  Appeals by Entities With Respect to Agreements (Certification) New Chap New  Sect Int. Pub 13-3 Carrier Pub 14-3 RHC Pub. 27 Program Memo Description 9 210   RHC-320  Content and Terms of Agreements 9 210.1   RHC-321  Charges to Beneficiaries 9 210.2   RHC-322  Refunds to Beneficiaries 9 210.3   RHC-323  Treatment of Beneficiaries 9 220   RHC-330  Termination of Agreement 9 220.1   RHC-330  Termination of Agreement by Clinic or Center 9 220.2   RHC-331  Termination by CMS 9 220.3   RHC-332  Effect of Termination 9 220.4   RHC-333  Notice to the Public 9 220.5   RHC-334  Conditions for Reinstatement of Clinic or Center Terminated by CMS
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Medicare Claims Processing Manual  Chapter 10 - Home Health Agency Billing   Table of Contents  (Rev. 12306, 10- 19-23)    Transmittals for Chapter 10  10 - General Guidelines for Processing Home Health Agency (HHA) Claims  10.1 -  Home Health Prospective Payment System (HHPPS)  10.1.1 -  Creation of HH PPS and Subsequent Refinements  10.1.2 -  Reserved  10.1.3 -  RESERVED  10.1.4 -  The HH PPS Unit of Payment               10.1.5 -  Number, Duration, and Claims Submission of HH PPS                                   Periods   of Care  10.1.5.1 -  More Than One Agency Furnished Home Health Services  10.1.5.2 -  Effect of Election of Medicare Advantage (MA) Organization and Eligibility Changes  10.1.6 -  RESERVED   10.1.7 -  Basis of Medicare Prospective Payment Systems and Case- Mix 10.1.8 -  Coding of HH PPS Case -Mix Groups on HH PPS Claims:                    HHRGs and HIPPS Codes  10.1.9 -  Composition of HIPPS Codes for HH PPS  10.1.10 -  Provider Billing Process Under HH PPS  10.1.10.1 -  Grouper Links Assessment and Payment  10.1.10.2 -  RESERVED  10.1.10.3 -  Submission of the Notice of Admission (NOA)  10.1.10.4 -  Claim Submission and Processing 10.1.11 -  Payment, Claim Adjustments and Cancellations  10.1.12 -  RESERVED  10.1.13 -  Transfer Situation -  Payment Effects  10.1.14 -  Discharge and Readmission Situation Under HH PPS -  Payment Effects  10.1.15 -  Payment Adjustments -  Partial Period Payment Adjustment  10.1.16 -  Payment When Death Occurs During an HH PPS Period  10.1.17 -  Payment Adjustments -   - Low Utilization Payment Adjustments (LUPAs)  10.1.18 -  RESERVED
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10.1.19 -  Payment Adjustments  Applying OASIS Assessment Items to Determine HIPPS Codes  10.1.20 -  RESERVED  10.1.21 -  Payment Adjustments  - Outlier Payments  10.1.22 -  RESERVED   10.1.23 -  Changes in a Beneficiarys Payment Source  10.1.24 -  Glossary and Acronym List  20 - Home Health Prospective Payment System (HH PPS) Consolidated Billing 20.1 -  Beneficiary Notification and Payment Liability Under Home Health Consolidated Billing  20.1.1 -  Responsibilities of Home Health Agencies  20.1.2 -  Responsibilities of Providers/Suppliers of Services Subject to Consolidated Billing  20.1.3 -  Responsibilities of Hospitals Discharging Medicare Beneficiaries to Home Health Care  20.2 -  Home Health Consolidated Billing Edits in Medicare Systems  20.2.1 -  Nonroutine Supply Editing  20.2.2 -  Therapy Editing 20.2.3 -  Other Editing Related to Home Health Consolidated Billing  20.2.4 -  Only Notice of Admission (NOA) Received and Services Fall Within Admission Period   20.2.5 -  No NOA Received and Therapy Services Rendered in the Home   30 - Common Working File (CWF) Requirements for the Home Health Prospective Payment System (HH PPS)  30.1 -  Eligibility Query to Determine Status  30.2 -  CWF Response to Inquiry  30.3 -  Timeliness and Limitations of CWF Responses  30.4 -  Provider/Supplier Inquiries to MACs Based on Eligibility Responses  30.5 -  National Home Health Prospective Payment Episode History File  30.6 -  Opening and Length of HH PPS Periods of Care  30.7 -  RESERVED              30.8-  RESERVED              30.9 -  Coordination of HH PPS Claims With Inpatient Claim Types   30.10 -  RESERVED             30.11 -  Exhibit: Chart Summarizing the Effects of NOA/Claim Actions on the HH PPS Episode File
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30.9 -  Coordination of HH PPS Claims With Inpatient Claim Types   30.10 -  RESERVED             30.11 -  Exhibit: Chart Summarizing the Effects of NOA/Claim Actions on the HH PPS Episode File   40 - Completion of Form CMS -1450 for Home Health Agency Billing 40.1 -  Notice of Admission (NOA)  40.2 -  HH PPS Claims  40.3 -  HH PPS Claims When No RAP is Submitted -  No -RAP LUPAs  40.4 -  Collection of Deductible and Coinsurance from Patient  40.5 -  RESERVED  50 - Beneficiary -Driven Demand Billing Under HH PPS  60 - No Payment Billing  70 - HH PPS Pricer Program  70.1 -  General  70.2 -  Input/Output Record Layout  70.3 -  RESERVED  70.4 -  Decision Logic Used by the Pricer on Claims  70.5 -  Annual Updates to the HH Pricer  80 - HH Grouper Program   80.1 -  HH Grouper Input/Output Record Layout   80.2 -  HH Grouper Decision Logic and Updates  90 - Medical and Other Health Services Submitted Using Type of Bill 034x 90.1 -  Osteoporosis Injections as HHA Benefit  90.2 -  Billing Instructions for Pneumococcal Pneumonia, Influenza Virus, and Hepatitis B Vaccines  90.3  Billing Instructions for Disposable Negative Pressure Wound Therapy Services  100 -  Temporary Suspension of Home Health Services  110 -  Billing and Payment Procedures Regarding Ownership and CMS Certification Numbers (CCNs)  110.1 -  RESERVED  110.2 -  Payment Procedures for Terminated HHAs  10 - General Guidelines for Processing Home Health Agency (HHA) Claims (Rev.  2977, Issued; 06- 20-14, Effective: 09 -23-14; ICD- 10: Upon Implementation of ICD- 10, Implementation: 09 -23-14; ICD -10: Upon Implementation of ICD -10)  This chapter, in general, describes billing and claims processing requirements that are applicable only to home health agencies.  For general bill processing requirements refer to the appropriate other chapters in the Medicare Claims Processing Manual.  For a description of home health coverage policies see Pub. 100- 02, Medicare Benefit Policy Manual, chapter 7.   A. Where and How to Bill
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A. Where and How to Bill   Institutional providers, including home health agencies, use one of two institutional claim formats to bill Original Medicare.  In the great majority of cases, these providers are required to use the electronic HIPAA standard institutional claim transactio n, the 837 institutional claim.  The minority of providers that are eligible for an exception to electronic claim submission use the paper Form CMS -1450, also known as the UB -04.  Such claim forms are submitted to certain Medicare Administrative Contractor s (A/B MACs (HHH)) with jurisdiction over home health and hospice claims.  Some home health agencies may also become approved as Durable Medical Equipment (DME) suppliers, in which case they would submit bills for DMEPOS services to the DME MACs on a profe ssional claim format (the 837professional or paper Form CMS -1500).  References to the claim form in this chapter refer to the paper Form CMS -1450 unless otherwise noted.  However, the instructions regarding specific data requirements apply also to the electronic 837 institutional claim.   B. Services to Include on the Claim for Home Health Benefits   Effective for all services provided on or after October 1, 2000, all services under the home health plan of care, except the following, are included in the home health PPS payment amount.  Services that may be included in the plan of care but excluded from  the HH prospective payment system (HH PPS) are:    Osteoporosis drugs (although the cost of administration is within the PPS rate); and   Durable medical equipment, including prosthetics, orthotics, and oxygen   The DMEPOS services may be included on type of bill (TOB) 032x for the home health benefits, and are paid in addition to the PPS payment.  See 20 for additional instructions regarding competitively bid DME.  Osteoporosis drugs must be billed on type of bill 034x.  Other services not under an HH plan of care provided by an HHA are billed using type of bill 034x.  See 90 for guidance as to the payment methodologies used by Medicare to reimburse these services, and see 40.4 in this chapter for information on deductible and coinsurance.
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10.1 - Home Health Prospective Payment System (HH PPS)  (Rev. 1, 10- 01-03) HH- 467, A3- 3639  10.1.1 - Creation of HH PPS and Subsequent Refinements  (Rev. 10758; Issued: 05- 11-21; Effective: 01 -01-22; Implementation: 08 -11-21)  The HH PPS was initially mandated by law in the Balanced Budget Act of 1997 and legislative requirements were modified in various subsequent laws. Section 1895 of the Social Security Act contains current law regarding HH PPS.   The initial implementation of the HH PPS was effective for dates of service on and after October 1, 2000.  Refinements to the case -mix system of the HH PPS system were for episodes of care beginning on and after January 1, 2008.   Effective for periods of care beginning on and after January 1, 2020, the original HH PPS system was updated to apply the Patient -Driven Grouping Model.  Home health Notices of Admission (NOAs) are required for periods of care beginning on and after January 1, 2022.   The sections that follow describe billing for services on or after January 1, 2022.  10.1.2 - Reserved  (Rev. 1348, Issued: 10- 05-07, Effective: 01 -01-08, Implementation: 11- 05-07)  10.1.3 - Configuration of the HH PPS Environment (Rev. 2230, Issued: 05- 27-11, Effective: 08- 28-11, Implementation: 08- 28-11)  The configuration of Medicare home health claim processing is similar to previous Medicare claims processing systems.  The flow from the HHA at the start of billing, to the receipt or remittances and electronic funds transfer (EFT) by the agency, to the recording of payment in either billing or accounting systems (bill/acct software) can be envisioned as follows:    CWF  SS/Contractor  Front End  SS/Contractor  Back End  PRICER  PS&R  Grouper  Billing  Software  Bank Bill./ Acct. Software  At HHA  At HHA  At Contractor  At CWF Host  Inquiries  RAP/Cl aim Batches  Inquiries  Claims  EFT Payment  Remittances  Checks  RAPs   Subsystems, also known as drivers or software applications or modules, have been created for HH PPS for Medicare home health claims processing.
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Subsystems, also known as drivers or software applications or modules, have been created for HH PPS for Medicare home health claims processing.    Grouper determines HHRGs for claims at HHAs by inputting OASIS data.  (OASIS is the clinical data set that currently must be completed by HHAs for patient assessment.)  OASIS software was updated to integrate the Grouper from the advent of HH PPS, and CMS has made Grouper specifications available on its Web site for those designing their own software.    ELGH is an inquiry system in CWF available via A/B MAC (HHH) remote access, through which HHAs and other providers can ascertain if a home health episode has already been opened for a given beneficiary by another HHA, and track episodes of beneficiaries fo r whom they are the primary HHA.  HHAs may also access this information via the HIPAA Eligibility Transaction System or HETS.  Refer to 30.1 and 30.2 for a detailed description.  Pricer software is used to process all HH PPS claims and is integrated into the Medicare claims processing systems.  In addition to pricing HIPPS codes for HHRGs, this software maintains national standard visit rate tables to be used in outlier and LUPA determina tions.  Refer to 70 for a detailed description of the Pricer software.  10.1.3 - RESERVED  (Rev. 10758; Issued: 05- 11-21; Effective: 01 -01-22; Implementation: 08 -11-21)  10.1.4 - The HH PPS - Unit of Payment  (Rev. 10758; Issued: 05- 11-21; Effective: 01 -01-22; Implementation: 08 -11-21)  The 30- day period of care is the unit of payment for HH PPS.  The period of care payment is specific to one individual homebound beneficiary.  It pays all Medicare covered home care that is reasonable and necessary for the patients care, including routine and nonroutine supplies used by that beneficiary during the period of care.  It is the only Medicare form of payment for such services, with the exceptions described in 10.B .  See 40 for details on billing these services.