Payment Adjustments - Partial Period Payment Adjustment

10.1.15 - Payment Adjustments - Partial Period Payment Adjustment (Rev. 10758; Issued: 05-11-21; Effective: 01-01-22; Implementation: 08-11-21) Both transfer situations and discharge and readmission to the same agency in a 30-day period result in shortened periods of care. In such cases, payment will be pro-rated. Partial period payment adjustments occur as a result of the two following situations: a. When a patient has been discharged and readmitted to home care within the same 30-day period of care; or b. When a patient transfers to another HHA during a 30-day period of care. Both situations are indicated on the claim by reporting a Patient Discharge Status code of 06. Based on the presence of this code, Pricer calculates a partial period payment adjustment to the claim. This is a proportional payment amount based on the number of days of service provided, which is the total number of days counted from and including the day of the first billable service to and including the day of the last billable service, divided by 30. The contractor shall use the following remittance advice messages and associated codes when paying partial period payment adjustments under this policy. This CARC/RARC combination is compliant with CAQH CORE Business Scenario Three. Group Code: CO CARC: B20 RARC: N120 MSN: N/A