Following is a table that I have developed to identify the incremental changes in revenue at each of the therapy visit ranges.
Please note that these revenues (total and change) are for a Service Area that has a Wage Index of 1.0000 and are based on a NRS Severity Level of 1:
2014 Wage Index of this Table: 1.0000 AFTER SEQUESTRATION
HHRG Episode # Therapy Visit Range PPS Pmt Change Cumm Change
C1F1S1 1 or 2 0 – 5 $1,724.60
C1F1S2 1 or 2 6 2,060.22 $335.61 $335.61
C1F1S3 1 or 2 7 – 9 2,396.39 336.18 671.79
C1F1S4 1 or 2 10 2,732.00 335.61 1,007.40
C1F1S5 1 or 2 11 – 13 3,068.18 336.18 1,343.57
C1F1S1 1 or 2 14 – 15 3,403.79 335.61 1,679.19
C1F1S2 1 or 2 16 – 17 3,844.33 440.54 2,119.73
C1F1S3 1 or 2 18 – 19 4,284.60 440.26 2,559.99
C1F1S1 ANY 20 + 4,724.86 440.26 3,000.26
C1F1S1 3 + 0 – 5 $1,412.34
C1F1S2 3 + 6 1,835.72 $423.38 $423.38
C1F1S3 3 + 7 – 9 2,259.11 423.38 846.77
C1F1S4 3 + 10 2,682.49 423.38 1,270.15
C1F1S5 3 + 11 – 13 3,105.59 423.10 1,693.25
C1F1S1 3 + 14 – 15 3,528.98 423.38 2,116.64
C1F1S2 3 + 16 – 17 3,927.60 398.63 2,515.26
C1F1S3 3 + 18 – 19 4,326.23 398.63 2,913.89
C1F1S1 ANY 20 + 4,724.86 398.63 3,312.52
Note: The above are at the NRS Level of 1
LEGEND:
- Column 1 – identifies the applicable HHRG Code
- Column 2 – identifies the episode timing: Early (1 or 2) or Late (3+) or Any (which is for any episode of 20+ Therapy Visits)
- Column 3 – identifies the applicable (i.e., allowable) Therapy Visit Range
- Column 4 – identifies the PPS Payment Rate for that applicable HHRG based on the Therapy Visit Range
- Column 5 – identifies the incremental change when moving from one level to the next
- Column 6 – identifies the Cumulative Change from the base-C1F1S1 PPS Rate
Note: These rates are based on an NRS Level of 1 (and there are 6 possible NRS Rates that each have their own incremental increase to the PPS Rate)