[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR484.210]



[Page 591]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 484_HOME HEALTH SERVICES--Table of Contents

 

      Subpart E_Prospective Payment System for Home Health Agencies

 

Sec. 484.210  Data used for the calculation of the national prospective 

60-day episode payment.



    To calculate the national prospective 60-day episode payment, CMS 

uses the following:

    (a) Medicare cost data on the most recent audited cost report data 

available.

    (b) Utilization data based on Medicare claims.

    (c) An appropriate wage index to adjust for area wage differences.

    (d) The most recent projections of increases in costs from the HHA 

market basket index.

    (e) OASIS assessment data and other data that account for the 

relative resource utilization for different HHA Medicare patient case-

mix.