CMS Issues Notice on Quarterly Update to Home Health Grouper 

Situation Report | June 14, 2021

The U.S. Centers for Medicare and Medicaid Services (CMS) has issued Medlearn Matters article 12303 for Certified Home Health Agencies (CHHAs) on the quarterly update to the Home Health (HH) Grouper.

The HH Grouper assigns each claim into a HH Resource Group (HHRG) based on the reported claim and patient assessment information, including diagnosis codes. The ICD-10-CM code set is updated annually, effective October 1. Each year, the Grouper contractor, 3M Health Information Systems (3M-HIS), develops a new HH Grouper software package to reflect these updates. CR 12303 implements this annual update. Additional HH Grouper updates may be needed if more CD-10-CM codes are created throughout the year.

HCA members can find the HH Grouper and related documentation on CMS’s website here.

Current instructions for the HH Grouper are in the Medicare Claims Processing Manual, Chapter 10, Section 80.

Version 03.0.21 of the HH Grouper will be effective for Medicare claims with “from dates” on or after October 1, 2021.