Delayed or Returned Home Health Claims Start the New Year

We have been hearing chatter of Home Health Providers experiencing delayed payments and/or returned claims as 2019 begins. Many are confused as to why! Back in August CMS released an MLN article reminding providers to add a specific code to Rural claims where services provided crossed over January 1st, 2019. This code is used to describe the geographical location of those services.


CMS exact language is...

"in the case of home health services furnished on or after January 1, 2019, the claim contains the code for the county (or equivalent area) in which the home health service was furnished.’’


Unfortunately there has been difficulty with Intermediaries processing these claims or the Home Health Providers are missing the specific code needed. As of today Palmetto GBA is fixing the issue for their region and will be processing claims as soon as possible. If you are a Provider and uncertain of what codes to use, below you will find the link to the MLN Article updated 12/31/18 and a link to the FIPS State and County codes needed.


MLN Matters MM10782

FIPS State and County Codes


For more information on claim status or adjusting your claims as necessary, please contact your RHHI.

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