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Know Jimmo | Payment Changes Did Not Change Coverage Criteria

September 26, 2024

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(From CMS 2/20/2020)

“Has Home Health Eligibility And Coverage Changed…

No. While there has been a change to the case-mix adjustment methodology and the unit of payment beginning in CY 2020, eligibility criteria and coverage for Medicare home health services remain unchanged. That is, as long as the individual meets the criteria for home health services as described in the regulations at 42 CFR 409.42, the individual can receive Medicare home health services, including therapy services. Payment under the HH PPS continues to be a bundled payment meant to cover all home health services as described at 42 CFR 409.44; including nursing, medical supplies, home health aides, and therapy services. …”  (Emphasis added)

– MLN Matters Article  – SE19027, 2/20/2020 www.cms.gov/files/document/se19027.pdf


Learn More

To learn more about the historic Jimmo Settlement, including watching a recording of CMA’s recent Jimmo Symposium – Jimmo v. Sebelius at 10 Years: A Call for Sustainable Implementation please visit the Jimmo section of our website by clicking here.


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