Medicare Claims Processing Manual (Pub. 100-04), Ch. 10 § 80.2
HH Grouper Decision Logic and Updates
80.2 – HH Grouper Decision Logic and Updates
(Rev. 11644, Issued: 10-13-22, Effective: 04-01-23, Implementation: 04-03-23)
The HH Grouper decision logic, in the form of Java computer software, and related
documentation are available to the public on the CMS website at:
www.cms.gov/Medicare/Medicare-Fee-for-Service-
Payment/HomeHealthPPS/CaseMixGrouperSoftware.html.
The major release of the Home Health Grouper is January 1st each year with changes
made as a result of the rulemaking process. There are two other off-cycle updates during
the year for new and deleted ICD10-CM diagnosis codes. These are April 1st and
October 1st each year. Whenever the HH Grouper is updated, Medicare also publishes a
Recurring Update Notification to inform providers and A/B MACs (HHH) about the
changes.