A home health agency (HHA) provides part-time skilled nursing services, therapeutic services, home health aide and medical social services to individuals confined to their homes. This section provides billing instructions for HHAs who file claims with HMSA.
Note: Aside from the information on Care Denial letters, the guidelines in this section do not apply to Medicare-based plans such as HMSA Akamai Advantage®.
Payment policy
Payment for HHAs is based on an all-inclusive rate for each episode of care, less any member copayment and/or deductible.
Included services
Typical services for HHAs include skilled nursing visits, skilled therapy visits (physical, occupational and speech), medical social services and home health aide. The all-inclusive rate for these services includes travel/transportation expenses, associated medical/surgical supplies and routine pharmacy items. Payment will not be made for home health care services furnished primarily to assist the beneficiary with personal, family or domestic needs.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform |