Home Health Billing Services
The rules are changing, but your revenue shouldn’t suffer. Partner with Revix MD for RCM solutions that navigate PDGM recalibration, OASIS-E2 updates, and HHVBP quality reporting with precision.
Technology-Driven Home Health RCM
Eliminate Late NOA Penalties. Master the 2026 PDGM Recalibration. Secure Your HHA Revenue.
Home Health Agency (HHA) billing is a high-stakes balancing act. With the CY 2026 CMS Final Rule implementing a net 1.3% aggregate payment reduction and a permanent 1.023% behavioral adjustment, your agency cannot afford administrative leakage. Revix MD provides an automation-first billing engine designed to navigate the complexities of Medicare home health certification, OASIS-E2 assessment accuracy, and 15-day PDGM cycles.
Mandatory RCM Expertise
CMS has updated nearly every facet of the PDGM model, making generic HHA billing companies obsolete for specialized home healthcare. Revix MD is built for the 2026 reality.
The 5-Day NOA Rule
Failing to file the Notice of Admission (NOA) within 5 calendar days results in a non-reimbursable day for every day it is late. We guarantee 48-hour submissions to ensure your agency never loses a covered day to “provider-liable” penalties.
HHVBP Quality Reporting
Value-Based Purchasing is now a national mandate. We apply our deep technical expertise to align your quality measure reporting with your billing data to ensure your annual payment adjustment reflects your clinical excellence under the Home Health Value-Based Purchasing (HHVBP) Model.
Permanent & Temporary Adjustments
We optimize your case-mix to offset the current -1.023% permanent reduction and the ongoing -3.0% temporary adjustment aimed at recouping retrospective overpayments.
Hospice Transition Coordination
We manage the critical billing handoff when patients transition from Part A Home Health to Hospice, preventing the common “overlapping episode” denials that strip HHA margins.
PDGM Case-Mix Optimization & OASIS-E2
Reimbursement under the PDGM model is driven by 432 unique case-mix groups. Our PDGM billing services ensure your agency is placed in the correct category by auditing:
Comorbidity Subgroup Adjustments
Identifying secondary diagnoses that qualify for “Low,” “High,” or “Multiple” adjustments, maximizing your per-period rate.
Clinical Grouping (12 Categories)
Utilizing ICD-10-CM codes that map correctly to one of the 12 clinical groupings (e.g., MMTA, Neuro Rehab).
Admission Source & Timing
Differentiating between Institutional vs. Community and Early vs. Late episodes.
OASIS Triple-Check
Our proprietary system ensures that the Plan of Care (POC), OASIS-E2 data, and physician orders are perfectly aligned before the claim is sent.
Functional Accuracy
We facilitate the mid-year transition to OASIS-E2, ensuring your clinical team is trained on the functional assessment markers that drive your 2026 HHA revenue.
F2F Flexibility
We leverage 2026 flexibility, allowing any allowed practitioner (NP/PA/CNS) to perform the F2F, regardless of whether they are the certifying provider.
Stress-Free 15-Day HHA Onboarding
Open Episode Mapping
We audit all active 15-day periods and pending NOAs to ensure zero payment gaps during the transition.
EMR & OASIS Expertise
Direct operational expertise within your EMR (Homecare Homebase, Kantime, WellSky) for automated HHVBP billing services.
LUPA & Compliance Training
We train your clinical staff on real-time LUPA monitoring and OASIS-E2 documentation markers.
High-Velocity RCM
Go-live with 48-hour NOA filings and aggressive home health denial management.
What HHA Leaders Are Saying
Revix MD mastered our PDGM billing during the 2026 recalibration. Their expertise in comorbidity subgroups increased our average period reimbursement by 12% while keeping us 100% audit-compliant.
Dr. John Codwell, Codwell Family Foot Center
Their OASIS assessment review caught dozens of functional scoring errors that would have cost us thousands. Transitioning to OASIS-E2 was seamless thanks to their proactive support.
Amer Khan, Omali Diagnostic, LLC
Don't let −3.0% rate cuts define your year.
Counteract Medicare rate cuts with precision PDGM coding and HHVBP optimization. Revix MD protects your margins, ensuring every 30-day period is billed at the maximum compliant rate.
Frequently Asked Questions
What is the national standardized 15-day payment rate for 2026?
The base rate is $2,038.22. Agencies that fail to submit required quality data or HHVBP metrics are subject to a 2% reduction, bringing the rate down to approximately $1,998.00.
How do you handle HHVBP quality measure reporting?
We apply our technical expertise to align your billing data with your clinical outcome measures. This ensures your HHVBP billing services are optimized for the maximum positive payment adjustment based on your Total Performance Score.
How do you prevent LUPA transitions mid-episode?
We provide real-time alerts as you approach the LUPA threshold for each specific case-mix group. This allows your clinical team to make informed visit-frequency decisions before a payment drop occurs.
Can you manage billing during a CMS Targeted Probe and Educate (TPE) review?
Yes. We have a 99% ADR pass rate. Our team manages the entire documentation packet, ensuring your F2F narratives and homebound status documentation are bulletproof.
Do you support state Medicaid home health waiver billing?
Yes. We manage specialized billing for state-specific 1115 and 1915(c) waivers, ensuring your private duty or community-based services are reimbursed at the correct state-mandated rates.
What happens to our open episodes when we transition to Revix MD?
We perform a “clean-cut” transition. We take over the billing for all open episodes from the date of go-live, ensuring that NOAs and final claims for the current 30-day period are filed without interruption.