Jurisdiction M (JM) Home Health and Hospice (HHH) POE Advisory Group (POE-AG) Minutes: January 14, 2021

Dan George, MaKisha P. Callaham, Cara Mia Wilkins, Elizabeth L. Brogdon and Charles Canaan

Attendees: 15

Our goals are:

  • Establishing and maintaining strong relationships with Palmetto GBA and our provider community
  • Meeting with Palmetto GBA and the provider community on a quarterly basis
  • Providing the communication tools to facilitate thorough and prompt transfer of information
  • Coordinating issues within the provider community to adequately reflect the concerns of the majority

POE-AG Goals and PurposeHHH POE-AG Charter

Old Business: Prior POE-AG Suggestions and Recommendations
Can Palmetto GBA to create a guide or job aid for the RAP changes in 2021?

  • In collaboration with CGS and NGS, Palmetto GBA is creating education FAQ for all MACs to post

New Business: POE-AG Training Suggestions and Education Recommendations
Participating members have the opportunity to benefit the provider community by helping to guide Palmetto GBA educational strategy for the upcoming year.

Information to Share

  • Home Health RAP Workaround
    • In 2021, it’s optional for you to report a Core-Based Statistical Area (CBSA) code using value code 61 for home health Requests for Anticipated Payment (RAPs). However, Medicare systems are returning RAPs without value code 61 in error. Your Medicare Administrative Contractor will add value code 61 and placeholder CBSA code 10180 to these RAPs so they continue processing. You do not need to take any action and may disregard the added codes.
  • Individual & Roster Billing for Influenza & Pneumococcal Pneumonia Vaccines
    • This job aid provides information on individual and roster billing for influenza and pneumococcal pneumonia vaccines (PPVs) for home health and hospice agencies
  • The Medicare Home Infusion Therapy (HIT) Benefit and Home Health Agencies 
    • If you are a home health agency (HHA) that wants to provide and bill Medicare Home Infusion Therapy (HIT) professional services starting in calendar year (CY) 2021, you are required to enroll with the Part B Medicare Administrative Contractor (A/B MAC) in your state. HHAs will no longer be able to bill professional HIT services on standard 837/CMS-1450 (UB-04) institutional claims form with their professional home health services.
  • 2021 Provider Contact Center Training and Holiday Closure Schedule

COVID-19 Updates
Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Suspended Through March

  • The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31. The Consolidated Appropriations Act, 2021, signed into law on December 27, extends the suspension period to March 31, 2021.

RCD News

Upcoming Education Events

  • Understanding the Hospice Election Statement Addendum: January 19, 2021
    • Provider Outreach and Education will be hosting a special 60-minute collaborative webinar with the other hospice Medicare Administrative Contractors (CGS and NGS) to provide education specific to the hospice election statement addendum regulations that were initiated this season. This live webinar will offer educational information, examples, resources and a live Q&A with the POE representatives from NGS, CGS and Palmetto GBA.
  • Ask the Contractor Teleconferences (ACT) — 2021 Schedule
    • The teleconference call-in for all dates is 800-374-0740 and all are scheduled for 1 p.m. ET
      • April 13, 2021 – Pass Code: 9084216
      • July 13, 2021 – Pass Code: 3535248
      • October 12, 2021 – Pass Code: 4087857


    • Your eServices administrator can add and remove users, as well as grant access to a variety of eServices features for all active users. We are pleased to announce that the Palmetto GBA eServices portal will now display the names of up to three administrators, which are viewable by all active users. Providers will no longer have to call our Provider Contact Center (PCC) to retrieve this information.
    • We are pleased to announce that providers will soon be able to view overpayment balance information via our eServices online portal. Currently, providers do not have the ability to view their active overpayment balances and must contact the Provider Contact Center (PCC) to obtain this information. At Palmetto GBA, we are committed to enhancing the provider experience. This is another step in enhancing our one stop shop for providers to view their financial data.

Open Discussion

Question: Can HHAs bill for COVID-19 Vaccines?

Answer: Yes. If you’re enrolled in Medicare as an HHA or hospice, you don’t need to take any Medicare enrollment actions to administer and bill the COVID-19 shot. The coding for COVID-19 Vaccines and Monoclonal Antibodies is available on the CMS website. Please note that providers should not bill for the product if they received it for free, but may bill for the administration of the product.

Question: The Claims Payment Issues Log article “Home Health Reason Code W7216 — Requests for Anticipated Payments (RAPs) Returned to Provider (RTP) Incorrectly for an Invalid Line Item Date” impact the 5-day RAP submission?

Answer: No, the actual RAP received date will remain as we bypass the edit and allow the RAP to process.

Question: Just to clarify, the HIT benefit is only for the infusion codes included in MLN Matters Number: MM11880.

Answer: That is correct, and a very good point. Palmetto GBA has updated the “The Medicare Home Infusion Therapy (HIT) Benefit and Home Health Agencies” article to clarify that information.

Next Meeting: April 15, 2021


Last Updated: 02/04/2021