CMS Transmittal Includes Instructions for Submitting Home Health Notices of Admission in 2022 

Situation Report | May 17, 2021

The U.S. Centers for Medicare and Medicaid Services (CMS) has recently issued Transmittal 10758 instructing Medicare home health agencies (HHAs) on the submission of one-time Notices of Admission (NOAs) beginning on January 1, 2022. The NOAs will be replacing home health No-Pay Requests for Anticipated Payment (RAPs) that were implemented for Calendar Year (CY) 2021.

Starting in CY 2022, HHAs must submit a NOA to their Medicare contractor within five calendar days from the start-of-care date. The NOA is a onetime submission to establish the home health period of care and covers contiguous 30-day periods of care until the individual is discharged from Medicare home health services.

NOA submission criteria will require HHAs to have a verbal or written order from the physician that contains the services required for the initial visit. The HHA must also have conducted an initial visit at the start of care.

Payments will be reduced when the HHA does not submit the NOA within five calendar days from the start of care: a 1⁄30th reduction to the wage-adjusted 30-day period payment amount for each day from start of care until the date the HHA submitted the NOA. No low utilization payment adjustment (LUPA) per-visit payments shall be made for visits that occurred on days that fall within the period of care prior to the submission of the NOA.

CMS will also be issuing a future Medlearn (MLN) article on this issue through the MLN Connects weekly newsletter.