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Upcoming Changes to the Home Health RAP Payment Policies

Date: 12/17/20

Earlier you received a notification from CMS regarding changes to the Home Health (HH) Request for Anticipated Payment (RAP) payment polices for 2021. You will want to be sure your billing staff is aware of these changes.
 
Important changes for 2021 include:

  • CMS has already discontinued RAP payments for any providers newly enumerated after 2019; however in 2021 RAP payments will be discontinued for all other Home Health Agency (HHA) providers.
  • CMS will reduce the split-percentage payment amount, paid in response to a RAP, to 20 percent for existing HHAs beginning in CY 2020 with elimination of split-percentage payments for all HHAs in CY 2021.
  • For CY 2021, there will be no up-front payment made in response to a RAP; however, RAPs will still be submitted by all HHAs every 30 days to alert the claims processing system that a beneficiary is under a home health period of care. HHAs must submit the zero-pay RAP within 5 calendar days of each 30-day period or be subject to a late penalty.
  • For CY 2021, CMS is reducing administrative burden by streamlining the information required in order to submit the RAP. CMS believes that phasing out the RAP payments will mitigate potential fraud and is an important step in paying responsibly and appropriately for home health services.

For more information, please review the MLN Matters article: Penalty for Delayed Request for Anticipated Payment (RAP) Submission – Implementation.

Thank you for your partnership. If you have any questions, please contact your Provider Relations Representative at 1-877-600-5472.