Home Health

The shift to PDGM fundamentally changed how reimbursement is calculated, moving away from volume and placing greater weight on clinical characteristics, documentation accuracy, and episode timing. According to CMS guidelines, reimbursement in home health is directly influenced by how well patient conditions, functional status, and care needs are documented. This creates a strong dependency between […]

Home health reimbursement depends on choosing the correct service line for the care delivered, discipline, clinician type, visit intent (restorative vs. maintenance), time, and setting must all map cleanly to the claim. When that mapping is consistent, PDGM logic behaves, edits drop, and payments land on the first pass. This guide distills the small set […]

In home health billing, denials come from the same small mistakes repeating across dozens of claims. A missed NOA deadline here, a vague nurse note there, an OASIS code that doesn’t match the diagnosis, and suddenly, cash flow slows, audits stack up, and staff morale dips. When billing teams analyzed hundreds of rejection reports from […]

If you’ve worked in home health billing long enough, you know one thing, Medicare never sits still. Each year brings new rules, rate recalibrations, and compliance details that directly affect how agencies get paid. And 2026 is no different. Between a proposed 6.4% payment cut, PDGM recalibration, and some quality reporting and value-based changes, billing […]