This regulation governs payment adjustments for home health agencies participating in the Home Health Value-Based Purchasing (HHVBP) Model, a Medicare payment initiative. CMS calculates upward or downward payment adjustments based on each agency's Total Performance Score using a linear exchange function. This rule is specific to Medicare home health payment methodology and does not govern any behavioral health, IDD, ABA, or foster care facility type.
View official source§ 484.325 Payments for home health services under Home Health Value-Based Purchasing (HHVBP) Model. CMS will determine a payment adjustment up to the maximum applicable percentage, upward or downward, under the HHVBP Model for each competing home health agency based on the agency's Total Performance Score using a linear exchange function. Payment adjustments made under the HHVBP Model will be calculated as a percentage of otherwise-applicable payments for home health services provided under section 1895 of the Act (42 U.S.C. 1395fff).