Hospice Routine Home Care Targeted Probe and Educate (TPE) Refinement

Published 03/10/2020

Palmetto GBA has refined the Routine Home Care Targeted Probe and Educate (TPE) edit for hospice. Providers who had pending ADRs prior to February 13, 2020, should respond with documentation to support the adjudication of the current suspended claims. Providers will be given credit for the reviews prior to the refinement of the edit when Palmetto GBA resumes the claim selection for this TPE action.

The edit was reengaged for Routine Home Care as of February 13, 2020. Palmetto GBA shifted the focus of the editing and claim selection to place of services where the Routine Home Care is being given as defined by OIG reports and internal data analytics to match the provider selection criteria.

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