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Home Health
A Home Health Agency is a Medicaid-enrolled organization that provides skilled nursing, therapy, and home health aide services part-time and intermittently. Home Health services are provided for beneficiaries requiring medically necessary health services to treat an injury, illness or disability.
Home Health does not include a provision of personal care services. Personal care services are available through the Michigan Department of Health and Human Services (MDHHS) Home Help program.
Electronic Visit Verification (EVV)
As of June 1, 2024, MDHHS has implemented a hard cutover to EVV for dates of service on and after April 1, 2024, for required HHCS codes. As of June 1, 2024, EVV required HHCS codes for dates of service on and after April 1, 2024 must be billed through HHAeXchange only. The state’s EVV system, HHAeXchange, will allow a claim to be created and submitted to CHAMPS once an EVV record is complete. Missing or incomplete EVV records will prevent a claim from being created and will impact provider payment. MDHHS implemented EVV for FFS HHCS providers in two phases as outlined in L Letter 24-17.
For new Home Health Agency providers who complete the CHAMPS enrollment application they should move on to the next step and complete the HHAeXchange provider onboarding form. This will allow HHAeXchange to create the EVV provider portal and work with the Agency to begin the EVV process. The onboarding form must be completed even if the Home Health Agency plans to continue to use their existing EVV vendor.
To learn more about EVV visit www.Michigan.gov/EVV.
Visit the Michigan Information Center website at www.hhaexchange.com/info-hub/Michigan or call HHAeXchange at 1-866-576-1179.
CHAMPS Provider Contact Information
MDHHS utilizes provider email address information entered in the CHAMPS provider enrollment application to communicate with providers. Providers are responsible for maintaining accurate and valid email address information within their CHAMPS provider enrollment information. If the email address information is out of date or incorrect, enrolled providers will want to modify their enrollment information and submit it for approval.
For instructions on how to update or modify email addresses reference the Provider Enrollment webpage step-by-step enrollment guide resources.
Home Health Resources
CPT codes, descriptions, and two-digit modifiers only are copyrighted American Medical Association. All Rights Reserved.
The information on this page serves as a reference only. It does not guarantee that services are covered. Providers are instructed to refer to the Michigan Medicaid Provider Manual, MMP Bulletins, and other relevant policies for specific coverage and reimbursement policies. This information can be found on the Medicaid Policy, Letters & Forms web page. If there are discrepancies between the information on this page and the Medicaid Provider Manual, such as rate or coverage determinations, they will be resolved in favor of the Medicaid Provider Manual language.
Revenue Code Requirement Table
Electronic Visit Verification (EVV) Resources
- MDHHS Electronic Visit Verification (EVV)
- Centers for Medicare and Medicaid Services (CMS) Electronic Visit Verification (EVV)
- Home Health Service Codes Requiring EVV
The MDHHS Home Health Team reviewed EVV usage with providers, addressed provider concerns, and offered updates on policy and procedure. For a list of EVV Frequently Asked Questions (FAQ) visit the EVV Caregivers and Providers - FAQs (michigan.gov).
- October 3, 2024, Touchpoint Slides, HHAX Slides
- May 22, 2024, Recording, Slides
August 22,2025: Reminder, the first home health therapy claim received for a beneficiary will initiate the 60 consecutive-day period. Claims submitted must be in sequential order (e.g., 4/01/2025, 4/08/2025, 4/15/2025) to prevent the incorrect home health therapy start date. Additionally, it is advisable to submit one claim per beneficiary each week to avoid confusion and processing errors. Home Health Agencies who have identified paid claims in CHAMPS submitted in non-sequential order will need to initiate the claim void process within the HHAeXchange system to resubmit claims in sequential order.
- Agencies who bill directly in the HHAeXchange system reference this step by step instructions video for voiding claims or visit the Rebilling - Resubmissions and Adjustments webpage .
- Agencies who utilize an Electronic Data Interchange (EDI) vendor to submit claims to the HHAeXchange system can utilize the 837 Claim Files and Linked Contracts webpage for directions on voiding claims or visit the EDI Provider Rebilling webpage.
**Failure to initiate the claim void process, will result in reimbursement issues and an incorrect start date for the 60 consecutive-day period.**
For more information on home health therapy service limitations, refer to the Medicaid Provider Manual, Therapy Services chapter, Standard of Coverage and Service Limitations.
HHAeXchange Resources
- HHAeXchange Provider Onboarding Form
- HHAeXchange University/Learning Management System (LMS)
- Knowledge Base
- Getting Started Webinar
- Billing video
- Visit the Michigan Information Center website at www.hhaexchange.com/info-hub/Michigan or call HHAeXchange at 1-866-576-1179.
Home Health Agency (HHA): Rules & Regulations
State Resources and Regulations
- Medicaid Provider Manual
- Policy, Letters, and Forms
- Provider Enrollment
- MDHHS, Office of Inspector General - Midwestern Unified Program Integrity Contractor (UPIC) - Post Payment Audit Process
Federal Resources and Regulations
- Electronic Code of Federal Regulations / Title 42, Chapter IV, Subchapter G, Part 484 - Federal conditions of participation for Medicare-certified HHA's.
- Center for Clinical Standards and Quality / Survey & Certification Group - Survey & Certification: 14-14-HHA
- Michigan Department of Licensing and Regulatory Affairs / Federal Certification - Completion of the certification process is required to participate in Medicare/Medicaid as a home health agency.
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