Review Choice Demonstration (RCD) Updated Cycles for Providers in Texas

CMS will restart the RCD following the pause for COVID-19. Home Health claims in all demonstration states with billing periods on or after August 31, 2020, will be subject to review under the requirements of the choice selected.

RCD Cycle 1 for providers in the state of Texas has been updated due to the COVID-19 (PDF, 54 KB) pause. Cycle 1 began on March 2, 2020, and paused after one month. Recently, Palmetto GBA communicated that the remaining five months of the Cycle would begin on August 31, 2020 and end on January 31, 2021. After considering additional stakeholder feedback, CMS has determined that Cycle 1 will now end on September 30, 2020. Affirmation and Claim Approval rates will be calculated based on review decisions made between March 2, 2020, and September 30, 2020. Palmetto GBA will communicate Cycle 1 results to all providers no later than October 31, 2020.

All PCR decision during the pause will be included in the Cycle 1 affirmation rates.

Palmetto GBA will conduct postpayment review on claims subject to the demonstration that were submitted and paid during the pause. Review results for these claims will not be included in Cycle 1 claim approval rates.

For more information on the resumption of RCD, click visit the CMS website.