[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

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

[CITE: 42CFR484.235]



[Page 607]

 

                         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.  484.235  Methodology used for the calculation of the partial 



episode payment adjustment.



    (a) CMS makes a PEP adjustment to the original 60-day episode 

payment that is interrupted by an intervening event described in Sec.  

484.205(d).

    (b) The original 60-day episode payment is adjusted to reflect the 

length of time the beneficiary remained under the care of the original 

HHA based on the first billable visit date through and including the 

last billable visit date.

    (c) The partial episode payment is calculated by determining the 

actual days served by the original HHA as a proportion of 60 multiplied 

by the initial 60-day episode payment.