Home Health Agencies: New Billing Method in 2020

Starting Jan. 1, 2020, VA will require TriWest to align with Medicare’s new reimbursement model for home health agencies known as Patient-Driven Groupings Model (PDGM).

Currently, TriWest reimburses skilled home health care using the Medicare PPS methodology, but that will be updated to the new PDGM in 2020.

How will this affect providers? Home health agencies will now have to bill TriWest for every 30-day episode, rather than every 60-day episode. However, all other claims processes remain the same. Home health agencies will still complete and submit an OASIS and follow the same process for billing TriWest.