Current through September 2, 2024
Section 16.03.09.726 - HOME HEALTH SERVICES: PROVIDER REIMBURSEMENT01.Home Health Services. Payment for home health services is limited to the services authorized in Sections 720 through 722 of these rules and must not exceed the lesser of reasonable cost as determined by Medicare or the Medicaid percentile cap. a. The Medicaid percentile cap is revised annually, effective at the beginning of each state fiscal year. Revisions are made using the data from the most recent finalized Medicare cost reports on hand thirty (30) days prior to the effective date.b. Payment by the Department for home health will include mileage as part of the cost of the visit.c. Provider claims for services requiring EVV will include the corresponding EVV data elements listed in Subsection 724.04 of these rules. Provider EVV data will be submitted to the state's aggregator prior to billing claims. Claims corresponding to EVV data submissions are subject to a quality review in accordance with Subsection 210.10 of these rules.d. If a person is eligible for Medicare, all services ordered by the physician or licensed practitioner of the healing arts will be purchased by Medicare, except for the deductible and co-insurance amounts that the Department will pay.02.Medical Supplies, Equipment, and Appliances. Payment for medical supplies, equipment, and appliances is detailed in Section 755 of these rules.Idaho Admin. Code r. 16.03.09.726