HCPCS Level II for Home Health Agencies

Home health agencies (HHAs) bill Medicare primarily under the Home Health Prospective Payment System (HHPPS), which bundles most covered services into a per-episode or per-visit payment. However, HCPCS Level II codes are still used for certain supplies and items provided during a home health episode that may be separately billable or must be reported on the claim. A-codes for medical supplies and E-codes for DME items are common in home health billing. Browse A-codes and E-codes for relevant supply and equipment codes.

Medical and surgical supplies used during skilled nursing visits — wound care dressings, catheter supplies, ostomy products — may be reported on the home health claim. Whether they are packaged into the episode payment or separately payable depends on the supply type and whether the patient is in a home health episode at the time. Billers must understand the HHPPS packaging rules to avoid duplicate billing.

Some HCPCS codes are used in home health documentation and reporting even when they do not generate separate payment. Functional assessment codes and OASIS-related reporting codes may appear on claims as informational codes. Coding supervisors should maintain a list of codes required for reporting versus codes that drive payment.

Home health agencies must also track quarterly HCPCS updates for supply and DME codes they use regularly. A deleted supply code that is still in the agency's system will result in claim rejections. Review the quarterly changes log and coordinate updates with your billing system vendor each cycle.