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Correct Processing of Home Health Claims if the Request for Anticipated Payment (RAP) or Notice of Admission (NOA) Was More Than 30 Days Late and Correct Identification Critical Access Hospital Sub-Unit Discharges as Institutional Periods of Care

This Change Request ensures claims are systematically processed without payment if the RAP or NOA receipt date is more than 30 days after the claim From date. It also ensures discharges from Critical Access Hospital (CAH)-based inpatient rehabilitation units or inpatient psychiatric units correctly trigger institutional payment groups.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 13, 2021

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.