Home Health Agency Billing and Notice of Admission (NOA)

4.4 - Home Health Agency Billing and Notice of Admission (NOA) (Rev. 11218; Issued: 01-27-2022; Effective: 02-28-2022; Implementation: 02-28- 2022) This section applies to MACs who process Home Health claims. Prior to January 1, 2022, under the Prospective Payment System (PPS) Medicare made a split percentage payment for most Home Health PPS episode periods. The first payment was for a Request for Anticipated Payment (RAP), and the last was for a claim. As of January 01, 2022, Home Health Agencies (HHA) shall no longer submit RAPs for any Home Health period of care with a “from” date on or after January 1, 2022. Instead, for each admission to home health, the HHA notifies the Medicare systems via submission of an NOA. See Pub 100-04, Medicare Claims Processing Manual, Chapter 10, Home Health Agency Billing, for more detailed information regarding the processing of NOAs. MACs may identify instances where an HHA’s use of NOAs indicates potential fraud, waste or abuse. Upon identifying misuse of NOAs, the MAC shall initiate corrective action. Corrective action includes, but is not limited to, education, warnings, Corrective Action Plans, and referrals to the UPIC.