Medicare home health billing runs on 30-day periods and episodes. You submit a RAP (Request for Anticipated Payment) and then a final claim. Get the timing and the data wrong and payment slips or gets clawed back.
30-day periods and episodes
An episode is up to 60 days (two 30-day periods). You can submit a RAP at the start of each period to get a percentage of the expected payment upfront. The final claim goes in after the period (or episode) is complete. SOC date (M0090) anchors the first period; the rest follow from that.
What to get right
Submit the RAP within the required window (check CMS and your MAC). Final claim has to have all required documentation in the chart,OASIS locked, orders and face-to-face documentation present. Missing or inconsistent docs lead to denials or ADRs. Billing leads who’ve cleaned up backlogs recommend a simple dashboard: RAPs due this week, finals due this week, and any chart missing docs,so nothing slips. We have a Medicare billing checklist you can download: period and episode timing, RAP and final requirements, and a short pre-submit check. Use the button below to get it.