Medical Billing
Maximized claim payouts
Free Revenue Cycle Audit— Discover how much revenue your practice is leaving on the table.
In 2026, Home Health Agency billing is a high-stakes balancing act. With a net 1.3% aggregate payment reduction and a permanent 1.023% behavioral adjustment, your agency cannot afford administrative leakage. Revix MD’s automation-first billing engine navigates the complexities so you don’t have to.

2026 Base 30-Day Rate
Unique PDGM Case-Mix Groups
ADR Pass Rate
NOA Submission Guarantee
CMS has updated nearly every facet of the PDGM model, making generic HHA billing companies obsolete for specialized home healthcare. Revix MD is built for the 2026 reality.
Failing to file the Notice of Admission (NOA) within 5 calendar days results in a non-reimbursable day for every day it is late. We guarantee 48-hour submissions to ensure your agency never loses a covered day to provider-liable penalties.
Value-Based Purchasing is now a national mandate. We integrate your quality measure reporting with your billing data to ensure your annual payment adjustment reflects your clinical excellence and Total Performance Score.
We optimize your case-mix to offset the current −1.023% permanent reduction and the ongoing −3.0% temporary adjustment aimed at recouping retrospective overpayments, protecting your per-period margins.
We manage the critical billing handoff when patients transition from Part A Home Health to Hospice, preventing the common overlapping episode denials that strip HHA margins.
Matrix
Industry Avg
2026 HHA Performance Standards
NOA Submission Speed
4.8 Days
<48 Hours
LUPA Prevention Rate
8.2%
<4.1%
ADR/TPE Pass Rate
74%
99%
F2F Documentation Errors
12%
<1%
Reimbursement under the PDGM model is driven by 432 unique case-mix groups. Our PDGM billing services ensure your agency is placed in the correct category every time.
Differentiating between Institutional vs. Community and Early vs. Late episodes to ensure the correct base rate is applied from day one.
Utilizing ICD-10-CM codes that map correctly to one of the 12 clinical groupings (e.g., MMTA, Neuro Rehab) for the highest justified rate.
Differentiating between Institutional vs. Community and Early vs. Late episodes to ensure the correct base rate is applied from day one.
Our proprietary system ensures that the Plan of Care, OASIS-E2 data, and physician orders are perfectly aligned before the claim is sent.
We facilitate the mid-year transition to OASIS-E2, ensuring your clinical team is trained on the functional assessment markers that drive 2026 HHA revenue.
We leverage 2026 flexibility allowing any allowed practitioner (NP/PA/CNS) to perform the F2F, regardless of whether they are the certifying provider.
We build your homebound and medical necessity documentation to survive the most rigorous TPE and ADR audits from day one of service.
We audit all active 30-day periods and pending NOAs to ensure zero payment gaps during the transition.
Direct synchronization with your EMR (Homecare Homebase, Kantime, WellSky) for automated HHVBP billing services.
We train your clinical staff on real-time LUPA monitoring and OASIS-E2 documentation markers.
Go-live with 48-hour NOA filings and aggressive home health denial management from day one.
Revix MD mastered our PDGM billing during the 2026 recalibration. Their expertise in comorbidity subgroups increased our average period reimbursement by 12% while keeping us 100% audit-compliant.
David L. — Operations Manager, Evergreen Home Health
Their OASIS assessment review caught dozens of functional scoring errors that would have cost us thousands. Transitioning to OASIS-E2 was seamless thanks to their proactive support.
Linda K. — Director of Clinical Services, Coastal Home Care
Counteract Medicare rate cuts with precision PDGM coding and HHVBP optimization. Revix MD protects your margins, ensuring every 30-day period is billed at the maximum compliant rate.

The base rate is $2,038.22. Agencies that fail to submit required quality data or HHVBP metrics are subject to a 2% reduction, bringing the rate down to approximately $1,998.00.
We synchronize your billing data with your clinical outcome measures. This ensures your HHVBP billing services are optimized for the maximum positive payment adjustment based on your Total Performance Score.
We provide real-time alerts as you approach the LUPA threshold for each specific case-mix group. This allows your clinical team to make informed visit-frequency decisions before a payment drop occurs.
Yes. We have a 99% ADR pass rate. Our team manages the entire documentation packet, ensuring your F2F narratives and homebound status documentation are bulletproof.
Yes. We manage specialized billing for state-specific 1115 and 1915(c) waivers, ensuring your private duty or community-based services are reimbursed at the correct state-mandated rates.
We perform a “clean-cut” transition. We take over the billing for all open episodes from the date of go-live, ensuring that NOAs and final claims for the current 30-day period are filed without interruption.