Which code is used to identify billing under the Home Health Prospective Payment System?

• A. HIPPS code
• B. 60-day certification period
• C. Inpatient admission
• D. CASPER reporting system

Answer: (A)

Under the Home Health Prospective Payment System, billing is identified by HIPPS codes. These Health Insurance Prospective Payment System codes classify a patient’s clinical and functional characteristics, derived from the OASIS assessment data, into a payment category. The HIPPS code is what the claim uses to determine the reimbursement rate for the home health episode.

Other options don’t serve as the billing identifier for HH PPS: the 60-day certification period governs recertification timing rather than payment classification; an inpatient admission is a different care setting and not the HH PPS billing identifier; and the CASPER reporting system is for quality measurement and reporting, not for setting payment.