Certified Home Health Agency (CHHA) Rates
CHHA Billing Guidance
2019
- CHHA Episodic Multi-Provider Billing Guidance - December 5, 2019
2018
- EPS - CHHA Billing Guidance - December 26, 2018
2017
- EPS - CHHA Notification of Upcoming Audit - June 9 , 2017
- EPS - CHHA Billing Guidance - March 1 , 2017
- EPS - CHHA Notification of Upcoming Audit - June 9 , 2017
- EPS - CHHA Billing Guidance - March 1 , 2017
2013
- EPS - Billing Guidelines - April 9, 2013
2012
- EPS - Billing Update Regarding Medical Orders - October 10, 2012
- EPS - Billing Update Regarding Service Lines - Sept. 25, 2012
- EPS - Billing Update Regarding Assessment Dates - August 29, 2012
- EPS - Additional Billing Guidance - July 1, 2012
- EPS - Additional Q & A - April 10, 2012
- EPS - Payment Calculation Examples - 2012
- EPS - Updated Q & A - March 27, 2012
- EPS - Spend Down Guidelines - February 27, 2012
- EPS - Spend Down Q & A - March 27, 2012
CHHA Episodic Rates
Current CHHA Medicaid Episodic Rates
CY2023 and CY2024 CHHA Episodic Home Health Aide Minimum Wage Rates - September 3, 2024
- Dear Administrator Letter - (Web) - (PDF) - September 3, 2024
- CY2023 EPS HHA MW ROS Medicaid Rates - (Web) - (XLS) - (PDF) - September 3, 2024
- CY2024 EPS HHA MW Medicaid Rate - (Web) - (XLS) - (PDF) - September 3, 2024
CHHA - Episodic Payment System (EPS)
Effective May 1, 2012, a new Episodic Payment System (EPS) reimbursement methodology to reimburse CHHA providers for services provided to Medicaid patients receiving home care services takes effect. The EPS is based on a price for 60-day episodes of care which will be adjusted by patient acuity and regional wage differences. The EPS was recommended by the Medicaid Redesign Team (MRT Proposal #5) and authorized in the 2011-12 Enacted Budget. The EPS is designed to address the issue of rapid growth in Medicaid costs per patient by better aligning payments with needed services and is part of a broad effort to promote the development of care management arrangements for Medicaid recipients.
For additional detailed information regarding the calculation of various components of the Episodic Payment System (EPS) of the CHHA pricing, please read below. Questions related to the new payment system can be directed to the Bureau of Long Term Care Reimbursement electronic mailbox: CHHA-Rates@health.ny.gov
2024
2023
- EPS - Modified Grouper Due to Changes in the OASIS-E Tool - March 10, 2023
2022
2018-2021
2017
- EPS - NYC Minimum Wage Rate Adjustment Effective January 1, 2017
2015
- EPS - FLSA Rate Adjustments Effective October 1, 2015
- EPS - Rebasing of CHHA Episodic Payment System Effective October 1, 2015
- EPS - Letter to Agencies - August 7, 2015
- EPS - Revised Base Price, Resource Groups, Case Mix Indices, Outlier Thresholds, Statewide Rates - Effective October 1, 2015
- Calculation of New Base Price - Effective October 1, 2015
- EPS - New York City Wage Parity Adjustment - Effective October 1, 2015
- Calculation of NYC Wage Parity Adjustment - October 1, 2015
- EPS - Medicaid Grouper Summary (2013 Base Year) - rev. Effective October 1, 2015
- Medicaid Grouper Scoring (2013 Base Year) - rev. August 2015
- 2013 Medicaid Grouper - ICD10 Codes
- Medicaid Grouper - SAS Code - Revised August 19, 2015
- EPS - Regional Wage Index Factors - Effective October 1, 2015
- EPS - Weighted Average Rates for LUPAs and Outliers - Effective October 1, 2015
- EPS - Interim Rebasing Adjustment Effective April 1, 2015
2014
- EPS - New York City Wage Parity Adjustment - October 9, 2014
2013
2012-11
- EPS - Base Price, Resource Groups, Case Mix Indices, Outlier Thresholds, Rate Codes - Effective May 1, 2012
- EPS - Regional Wage Index Factors - Effective May 1, 2012
- EPS - Weighted Average Rates for LUPAs and Outliers - April, 2012
- EPS - New York State Medicaid Grouper
- EPS - Medicaid Grouper Summary - April 2012
- EPS - Medicaid Grouper Scoring - April 2012
- EPS - 2009 Medicaid Grouper - ICD9 Codes - rev. November 17, 2011
2009
- EPS - 2009 Medicaid Grouper - ICD10 Codes