CMS would like to announce the availability of a new Home Health Limited Data Set (LDS) file.
This file contains information on the utilization of the Medicare Home Health (HH) benefit. The file is constructed so that each observation represents a particular home health episode in a given year. As described in the proposed rule that presents the 2019 Home Health Prospective Payment System Rate Update and Proposed CY 2020 Case-Mix Adjustment Methodology Refinements, CMS is proposing refinements to the HH payment system that would change the length of a home health episode from 60-days to 30-days. That proposal meets the requirements of section 51001(a) of the Bipartisan Budget Act of 2018 to use 30-day periods. As such, this data file was constructed by splitting the current 60-day home health episodes into two 30-day periods. Each observation in the file represents a single 30-day period. However, some variables on the file were drawn from the 60-day episode from which the 30-day period was constructed, as indicated in the variable description. Information in this file includes:
- Start and end dates of the 30-day periods and 60-day episodes
- Wage index value associated with each episode/period
- Information regarding the resource use of the episode/period
- Payment adjustors used for the episode/period
- HIPPS codes
- Case-mix weights
- Indicators for whether the episode/period receives a payment adjustment (LUPA, PEP, outlier)
- Actual and simulated payments for the episode/period
- Information on number and length of visits that occur during the episode/period
- Select information from OASIS assessments that is used in the payment system.
This Home Health LDS file will be updated twice a year. The first update will correspond to annual notices of proposed rulemaking, released in the early summer, and the second update will correspond to final rules released in the fall. Proposed and final rule notices can be found on the Home Health Prospective Payment System website. Further information on the variables in the file can be found from
- The variable layout that accompanies this file (See the CMS LDS file web page.)
- The proposed rule that presents the 2019 Home Health Prospective Payment System Rate Update and Proposed CY 2020 Case-Mix Adjustment Methodology Refinements
- The “Overview of the Home health Groupings Model” technical report.
This Home Health LDS file will be updated twice a year. The first update will correspond to the NPRM released in the early summer and the second update will correspond to the final rule released in the fall.