BRS supports pricing under the Home Health Prospective Payment System (HH PPS), including:
- Claims priced in accordance with the Home Health Prospective Payment System (HH PPS)
- Wage index adjustment based on CBSA
- Low Utilization Payment Adjustment (LUPA) for episodes with few visits
- LUPA add-on for first episodes
- Pro-rating of episode rate for Partial Episode Payments (PEPs)
- Significant Changes In Condition (SCICs)
- HIPPS fallback and HIPPS recoding with the Treatment Authorization Code
- Processing of Requests for Anticipated Payment (RAPs) with optional payment reconciliation with episode final bill
- Type of Bill logic
- Consolidated Billing (CB) applied in accordance with the Home Health CB master list
- Outlier add-on for episodes with an unexpectedly large number of visits