Home Health LUPA Threshold: Bill Correctly

Published 06/04/2021

In a recent report, the Office of Inspector General found that Medicare improperly paid some claims for home health services with 5-7 visits in a payment episode. Review the Medicare Home Health Benefit (PDF,  383 KB) and Home Health Prospective Payment System (PDF, 406 KB) booklets to properly bill for services slightly above the Low Utilization Payment Adjustment (LUPA) threshold.

For more information, visit the Home Health Prospective Payment System (PPS) webpage and view these additional resources to stay informed on the latest policy and payment updates:

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