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Review the medicare home health benefit (pdf) and home health prospective payment system booklets to properly bill for services slightly above the low utilization payment adjustment (lupa) threshold. Under pdgm, the lupa threshold will vary by hhrg and will be based on the 30 days of care. Lupa stands for low utilization payment adjustment, a financial adjustment in the medicare home health prospective payment system (hh pps)
It occurs when a home health agency provides fewer visits than the minimum threshold required for a specific patient’s billing period. Lupa, or low utilization payment adjustment, is medicare’s payment reduction mechanism for home health episodes that don’t meet minimum visit thresholds. Learn what low utilization payment adjustment (lupa) means in home health, how cms calculates it, and strategies to reduce lupa rates while improving compliance.
Lupa stands for low utilization payment adjustment
In home health care, it’s a medicare payment rule What is lupa and when does it apply
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