National 30-Day Period Payment Rate

10.1 - National 30-Day Period Payment Rate (Rev. 12382; Issued: 11-28-23; Effective: 01-01-24; Implementation:01-02-24) A. Services Included The law requires the 30-day period to include all covered home health services, including medical supplies, paid on a reasonable cost basis. That means the 30-day period payment rate includes costs for the six home health disciplines and the costs for routine and nonroutine medical supplies. The six home health disciplines included in the 30-day period payment rate are: 1. Skilled nursing services; 2. Home health aide services; 3. Physical therapy; 4. Speech-language pathology services; 5. Occupational therapy services; and 6. Medical social services. The 30-day period payment rate also includes amounts for nonroutine medical supplies and therapies that could have been unbundled to Part B prior to HH PPS. (See §10.11.C for those services.) B. Excluded Services The law specifically excludes durable medical equipment (DME) from the 30-day period payment rate and consolidated billing requirements. DME continues to be paid the fee schedule amounts or through the DME competitive bidding program outside of the HH PPS rate. Certain injectable osteoporosis drugs which are covered where a woman is postmenopausal and has a bone fracture are also excluded from the 30-day period payment rate, but must be billed by the home health agency (HHA) while a patient is under a home health plan of care since the law requires consolidated billing of these osteoporosis drugs. These osteoporosis drugs continue to be paid on a reasonable cost basis. Negative pressure wound therapy using a disposable device (dNPWT) that is an integrated system comprised of a non-manual vacuum pump, a receptacle for collecting exudate, and dressings for the purposes of wound therapy (in lieu of a conventional NPWT DME system), is also excluded from the 30-day period payment rate, but must be billed by the home health agency (HHA) while a patient is under a home health plan of care since the law requires consolidated billing of NPWT using a disposable device. Furnishing NPWT using a disposable device means the application of a new applicable disposable device, as that term is defined in §1834 of the Social Security Act (the Act), which includes only the device paid separately (specified by the assigned HCPCS code) and does not include payment for the professional services.