Request for Anticipated Payment (RAP) Changes in 2021

As a reminder, home health agencies will no longer receive RAP payments for 30-day payment periods beginning on and after January 1, 2021.However, agencies are required to submit the RAP in a timely manner to avoid monetary penalties. This is in preparation for the transition to the Notice of Admission beginning in 2022.

Last week, it came to the attention of CMS and the Medicare Administrative Contractors (MAC) that some RAPs were being erroneously returned to provider.  The new RAP regulations allow agencies to exclude value code 61 with Core-Based Statistical Area (CBSA) when submitting the RAP.  That was the plan.  A glitch in the Medicare system has caused RAPs without this optional code and associated CBSA to reject.  A workaround has been established, and your MAC will add the value code 61 along with a placeholder CBSA code 10180 to ensure the RAP will continue to process.  Notices on the CMS and MAC websites are stating agencies “do not need to take any action and may disregard the added codes”.  One thing is certain–the priority of agencies should be timely submission to avoid the associated penalties.  Although not required, agencies may elect to submit the value code 61 and CBSA related to the location of the provided services to the beneficiary.