Home Health PPS and OASIS-C2


Reimbursement for care and services provided is an important administrative function for all home health agencies. Agencies cannot operate without revenue. While administrative staff usually perform billing-related tasks, as a clinician, you have a pivotal role in the reimbursement process. Because the majority of revenue generated by your home health agency likely comes from Medicare, it is important for you to have a basic understanding of the Home Health Prospective Payment System (HH PPS) for Medicare reimbursement. In this course, you will learn about the PPS, Medicare eligibility requirements, and the role of the OASIS in reimbursement. You will also learn strategies that you can use to help maximize your agency’s reimbursement under the PPS. This course relates to the Federal regulations G330, G331, G332, G333, G334, G335, G336, G338, G339, and G340.


Hours: 1.25


Certificates provided by accrediting body (10 Match)

California Board of Registered Nursing

1.25 HOURS

Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.25 contact hours for participating in this course.

District of Columbia Board of Nursing


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.20 contact hours for participating in this course.

Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling

1.25 HOURS

Provider #50-290 This activity is approved for 1.25 contact hours.

Florida Board of Nursing CE


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

American Nurses Credentialing Center

1.25 HOURS

Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.25 contact hours for participating in this course.

Georgia Board of Nursing

1.25 HOURS

Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.25 contact hours for participating in this course.

South Carolina Board of Nursing

1.25 HOURS

This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

Association of Social Work Boards

1.25 HOURS

Relias, LLC, #1273, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education (ACE) program. Relias, LLC maintains responsibility for the program. ASWB Approval Period: 2/10/2018-2/10/2021. Social workers should contact their regulatory board to determine course approval for continuing education credits.

Course Delivery Format: Asynchronous Distance Learning-interaction includes quizzes with questions and answers, posttests. This module is Text-based.

Social workers participating in this course will receive 1.25 Clinical continuing education clock hours.

New York State Education Department, Office of the Professions, Division of Professional Licensing Services, Social Work Unit

1.25 HOURS

Relias, LLC is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0009.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of licensed master social work and licensed clinical social work in New York. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice for an LMSW and LCSW. A licensee who practices beyond the authorized scope of practice could be charged with unprofessional conduct under the Education Law and Regents Rules.

As a provider of online, asynchronous education, some courses offered by Relias Learning are considered “self-study” under section 74.10(c)(2)(ii)(b)(4) of the Commissioner’s Regulations. The regulations limit self-study activities taken from a provider approved by the Education Department to no more than 12 hours in the 36-month registration period or one-third of the hours in a registration period other than 36 months.

Social workers will receive 1.25 continuing education hours for participating in this course. This activity is approved for 1.25 contact hours.

Texas Health and Human Services Commission

1.25 HOURS

Texas HHSC has determined that Relias Learning’s submitted training meets or exceeds the minimum standards for HCSSA administrator training in the following categories: Licensed and Certified Home Health (L&CHH). Texas HHSC also recognizes Relias Learning provides continuing education for administrators and alternate administrators. This activity is approved for 1.25 contact hours.

Course Details

Course Code: REL-SRC-0-HHPOC-V2
Hours: 1.25
Type: Online Course
Content Expiration Date: 11/30/2020
Learning Objectives:
Explain the situations in which two types of payment under the PPS would be applicable.

Describe three Medicare eligibility requirements for reimbursement in home care.

Identify four OASIS completion requirements for Medicare reimbursement.

Explore three strategies to use to maximize reimbursement under the PPS.

Section 1: Introduction A. About This Course B. Learning Objectives Section 2: The Prospective Payment System A. The Beginning B. The HH PPS C. 60-Day Episode D. Case-Mix Adjustments E. Low Utilization Payment Adjustment F. Partial Episode Payment Adjustment G. Outlier Payments H. Discharge Issues I. Consolidated Billing J. Review K. Summary Section 3: Medicare Eligibility Requirements A. Eligibility Requirements B. Homebound Status C. Plan of Care D. Coverage for Skilled Nursing E. Observation and Assessment F. Managing the POC G. Teaching and Training H. Wound Care I. Venipuncture J. Other Nursing Services K. Coverage for Therapy Services L. The Face-to-Face Encounter M. Review N. Summary Section 4: The Role of OASIS A. Comprehensive Assessment B. History of the OASIS C. OASIS Time Points D. Who Completes the OASIS? E. “M” Items F. Review G. Summary Section 5: Strategies for Success A. Maximizing Reimbursement B. Being Successful C. Assessment Strategies D. Completion of the OASIS E. ADL Items F. The Importance of Documentation G. Review H. Summary Section 6: Conclusion A. Summary B. Course Contributor C. Resources D. References E. Congratulations

Instructor: Barbara Knott, RN, MPA, ACHCE
Ms. Knott has 36 years of experience in healthcare, with the last 34 years spent in the home care field. She has been responsible for agency regulatory and accreditation compliance as well as quality assurance programs for home health and hospice. In her current position, she has oversight of the financial, operational, and quality performance of multiple home healthcare providers. Ms. Knott has received certification as an Advanced Certified Home Care Executive. Disclosure: Barbara Knott, RN, MPA, ACHCE has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: entry level Case Managers; entry level Nurses; entry level Social Workers; in the following settings: Home Health.
G Tags:
G322, G350, G370, G374, G472, G510, G512, G514, G516, G518, G520, G522, G524, G526, G528, G530, G532, G534, G536, G538, G540, G542, G544, G546, G548, G550, G610, G700, G702, G704, G714
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
If you require special accommodations to complete this module, please contact Relias Customer Support by calling (800) 381-2321 or emailing support@relias.com