In this episode of AHCC Talk, we break down the face-to-face (F2F) requirement for home health—a critical condition of payment tied to compliance and reimbursement.

Learn what qualifies as a valid encounter, who can perform it, and how to avoid the most common documentation mistakes that lead to denials.

We also cover timing rules, telehealth updates through 2027, and practical strategies to ensure your agency stays compliant and audit-ready.

Perfect for coders, clinicians, and compliance professionals navigating home health regulations.This episode's panel includes:

✅ Jan Milliman, HCS-D, Director, AHCC

✅ Lisa Selman-Holman, JD, BSN, RN, HCS-D, HCS-H,HCS-O, COS-C, Vice President of Clinical Services, McBee

✅ Lisa McClammy, BSN, RN, COS-C, HCS-D,HCS-O, Senior Clinical Education Consultant, MAC Legacy

Links Mentioned in the Episode

🔗 § 424.22 Requirements for home health services. https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-424/subpart-B/section-424.22

🔗 A Rule by the Centers for Medicare & Medicaid Services on 12/02/2025: https://www.federalregister.gov/documents/2025/12/02/2025-21767/medicare-and-medicaid-programs-calendar-year-2026-home-health-prospective-payment-system-hh-pps-rate

🔗 Palmetto GBO: Home Health Face to Face Checklist: https://dominoapps.palmettogba.com/palmetto/providers.nsf/files/Home_Health_Face_to_Face_Checklist.pdf/$FILE/Home_Health_Face_to_Face_Checklist.pdf

🔗 Join us May 19-21 at the Home Care Leadership Summit in Orlando, FL: decisionhealth.com/hcls2026

🔗 Join us for the next live airing of AHCC Talk: https://attendee.gotowebinar.com/register/2224811617290518541?source=yt

🔗 Learn more about AHCC and how to become a member:store.decisionhealth.com/join-ahcc🔗 NEW BOOK: Home Health Guide to Crafting a Compliant Plan of Care, 1st Edition: ⁠https://store.decisionhealth.com/2026-plan-of-care-guide⁠

⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/media/1774/ahcc-talk-episode-89-handouts.pdf

📧Have a question, episode request, or suggestions for a future panel guest? Email Jan at jan.milliman@decisionhealth.com

In this episode of AHCC Talk, our expert panel discusses how to create and implement a compliant and individualized plan of care (POC).Learn how to:

• Meet Conditions of Participation requirements
• Develop meaningful goals and interventions
• Avoid common plan of care audit risks
• Individualize care plans for better outcomes
• Apply real-world POC examples

The discussion includes practical scenarios and guidance to help clinicians and agencies strengthen documentation and compliance.

✅ Jan Milliman, HCS-D, Director, AHCC

✅ Sherri Parson, RN,. HCS-D, HCS-O, COS-C, CEO,Infusion Health

✅J'non Griffin, RN, MHA, HCS-D, HCS-H,COS-C, Direction, SimiTree Healthcare Consulting

Links Mentioned in the Episode

🔗 NEW BOOK: Home Health Guide to Crafting a Compliant Plan of Care, 1stEdition: https://store.decisionhealth.com/2026-plan-of-care-guide

🔗Home Health J1800/J1900 Errata: https://www.cms.gov/files/document/oasis-e1-guidance-manual-errata-fmi-items.pdf

🔗October 2025 CMS Quarterly OASIS Q&As: https://qtso.cms.gov/system/files/qtso/CMS_OAI_Qtr_4_2025_QAs_October_2025_508c.pdf

🔗Join us May 19-21 at the Home Care Leadership Summit in Orlando, FL: decisionhealth.com/hcls2026

🔗Join us for the next live airing of AHCC Talk on March 16 at 1pm EST: https://register.gotowebinar.com/#register/2224811617290518541?source=podcast

🔗 Learn more about AHCC and how to become a member:store.decisionhealth.com/join-ahcc

⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/media/1773/ahcc-talk-episode-88-handouts.pdf

📧Have a question, episode request, or suggestionsfor a future panel guest? Email Jan at jan.milliman@decisionhealth.com

Falls are receiving greater scrutiny than ever before—and with the introduction of the new Falls with Major Injury (FMI) Outcome, accurate assessment, scoring, and documentation matter more than ever.

In this episode, our expert panel breaks down what’s changed, why it matters, and how clinicians and agencies should respond. From OIG findings and CMS definition updates to practical scoring tips for OASIS items J1800 and J1900, this discussion connects regulatory guidance to real-world clinical scenarios.

You’ll also learn how the FMI outcome is calculated, how risk adjustment works, and why the new methodology tells a different story about falls data—plus how agencies can focus on prevention without over- or under-reporting.

✅ Jan Milliman, HCS-D, Director, AHCC

✅ Lisa Selman-Holman, JD, BSN, RN, HCS-D

✅ Kelly Kavanaugh, RN, HCS-D, HCS-O, HCS-H

Links Mentioned inthe Episode

🔗 OASIS E1 Manual: https://www.cms.gov/files/document/draft-oasis-e1-manual-04-28-2024.pdf

🔗OASIS Quarterly Q&As October 2025:https://qtso.cms.gov/reference-and-manuals/oasis-quarterly-q

🔗OASIS Static Q&As: https://qtso.cms.gov/providers/home-health-agency-hha-providers/reference-manuals

🔗All OASIS materials can be found at: https://qtso.cms.gov/providers/home-health-agency-hha-providers/reference-manuals

🔗Home Health - Falls with Major InjuryRespecification: Technical Specification Report

https://www.cms.gov/files/document/fmi-technical-specification-report-hh.pdf-0List of codes found in Appendix B and Appendix C

🔗Home Health J1800/J1900 Errata: https://www.cms.gov/files/document/oasis-e1-guidance-manual-errata-fmi-items.pdf

🔗Join us for the next live airing of AHCC Talk on February 23 at 1pm EST: https://register.gotowebinar.com/#register/2224811617290518541?source=podcast

🔗 Learn more about AHCC and how to become a member:store.decisionhealth.com/join-ahcc

⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/ahcc-talk-episode-87-updates-for-classifying-falls-in-home-health/

📧Have a question, episode request, or suggestionsfor a future panel guest? Email Jan at jan.milliman@decisionhealth.com

In this episode of AHCC Talk, we break down what Medicare expects when it comes to medical necessity at recertification — and where agencies most often fall short.

Host Jan Milliman, HCS-D is joined by Lisa McClammy, BSN, RN, COS-C, HCS-D, HCS-O, Senior Clinical Education Consultant at MAC Legacy, to discuss:

• What documentation must show to justify continued skilled care
• Key elements that support recertification and homebound status
• Common documentation gaps that put agencies at risk
• Practical examples of when skilled services are — and are not — reasonable and necessary
• How progress to goals, functional status, and risk factors support compliance

This episode also features a Scenario Spotlight focused on OASIS M1033.1 - History of Falls, helping listeners apply guidance to real-world documentation decisions.

Links Mentioned in the Episode

🔗 AHCC certification study guides: decisionhealth.com/studyguides

🔗 If you're an AHCC member, register for the AHCC Member's Call on January 28 at 1pm EST: https://register.gotowebinar.com/register/8915984221266150240

🔗 Learn more about AHCC and how to become a member:store.decisionhealth.com/join-ahcc

⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/ahcc-talk-episode-86-medical-necessity-at-recert/

📧Have a question, episode request, or suggestionsfor a future panel guest? Email Jan at jan.milliman@decisionhealth.com

On this episode of AHCC Talk, our panel dives into diagnosis coding for hospice and how to accurately complete the Hospice Outcomes & Patient Evaluation (HOPE) tool, with a focus on Section I: Active Diagnoses. You’ll hear discussion of real-world charts, CMS guidance, and HOPE scenarios so you can feel more confident about aligning your claims, assessments, and documentation.

Our Panel

✅ Jan Milliman, HCS-D, Director, AHCC

✅ Kelly Kavanaugh, RN, HCS-D, HCS-H,HCS-O, BCHH-C, Independent Home Health and Hospice Consultant owner of The OTBGroup

✅ Lisa Selman-Holman, JD, BSN, RN, VP Education andQuality, McBee

Links Mentioned in the Episode

🔗 HOPE Assessment Tool: All About Active Diagnoses(CHAP): https://chapinc.org/blog-news/hope-assessment-tool-active-diagnoses/

🔗 Register now for the Home Care Leadership Summit happening in Orlando, FL from May 19-21, 2026decisionhealth.com/hcls2026 🔗 Free Webinar: HOPE Tool Training for Easy, Compliant Rollout https://web.hcpro.com/hope-training-tool

🔗 Learn more about AHCC and how to become a member:store.decisionhealth.com/join-ahcc

⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/ahcc-talk-episode-85-diagnosis-coding-and-the-hospice-hope-tool/

📧Have a question, episode request, or suggestions for a future panel guest? Email Jan at jan.milliman@decisionhealth.com

What truly defines a skilled service in home health—and why does it matter so much for compliance, reimbursement, and patient outcomes?

In this episode, host Jan Milliman, HCS-D, is joined by J'non Griffin, RN, MHA, HCS-D, HCS-H, HCS-C, COS-C and Apryl Swafford, RN, BSN, COS-C, HCS-D, HCS-H, HCS-O, both from SimiTree Healthcare Consulting, to break down how Medicare defines skilled service and what agencies need to document to defend it. From medical necessity to top denial drivers, this conversation covers the fundamentals every home health professional must master.

Whether you're a new clinician or a seasoned leader, this practical discussion will help you avoid pitfalls, strengthen documentation, and ensure services meet key requirements.

Links Mentioned in the Episode

🔗Medicare Benefit Policy Manual, Ch. 7 - Home Health Services: https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/bp102c07.pdf

🔗Learn More About AHCC credentials: decisionhealth.com/credentials

🔗 If you're an AHCC Member, please take the Member Survey!: https://www.surveymonkey.com/r/7SKBX2J

⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/ahcc-talk-episode-84-defining-skilled-need/

📧Have a question, episode request, or suggestionsfor a future panel guest? Email Jan at jan.milliman@decisionhealth.com

Join host Jan Milliman, HCS-D (Director, AHCC) with AHCC Advisory Board members Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C and Sherri Parson, RN, HCS-D, HCS-O, HCS-H, COS-C as we break down what’s new for FY2026—what changed, what matters, and how to apply it correctly in home health and beyond.

In this episode:

• Code transition implications for billing and documentation

• Specialty impacts (including hospice)

• Tabular/Index updates and notable new concepts (e.g., E11.A T2DM in remission)

• Obesity guidance (April 2025) + Coding Clinic Q1 2025 notes

• High-impact condition areas: hypercholesterolemia, multiple sclerosis, muscular dystrophy

• Hypertensive heart disease changes + new guideline and examples

• Wound and skin updates (L98.4 and related ulcer coding)

• COPD + other chronic bronchitis clarifications

• Anatomy/site updates (e.g., flank), pelvis reclassification to M80.0B

• Medication and risk concepts (fluoroquinolones, genetic susceptibility)

• Real-world scenario spotlights and an AHCC product/member update

CHAPTERS

1:29 Code Transition
2:15 What This Means for Billing
3:15 What About Hospice?
3:46 Inflammatory Breast Carcinoma
4:36 Tabular and Index Updates
5:29 E11.A – T2DM without complications in remission
7:10 E11.A Guideline
7:29 Diabetes Mellitus with Venous Insufficiency
8:40 Obesity – new guideline (Apr 2025), Coding Clinic Q1 2025
9:32 Hypercholesterolemia
10:08 Multiple Sclerosis
12:12 Muscular Dystrophy
13:24 Big Changes to Hypertensive Heart Disease
14:39 New Guideline – Hypertension with Heart Disease
16:16 HTN Examples
17:21 L98.4 – Non-pressure chronic ulcer of skin, NEC
18:22 Related to Ulcer Codes
20:10 COPD with Other Chronic Bronchitis
21:16 Flank added as a new anatomic site
22:13 Pelvic parts moved to M80.0B Pelvis
23:06 Fluoroquinolones
24:05 Genetic Susceptibility
25:47 Scenario Spotlight
26:06 August Scenario
27:52 August Scenario Answer
28:40 September Scenario
29:30 Product Spotlight: Home Health Pro
30:00 What’s New with AHCC: Advisory Board Update; Member Survey

RESOURCES & LINKS

• CMS ICD-10-CM code files: https://www.cms.gov/medicare/coding-billing/icd-10-codes

• Learn more about Home Health Pro: decisionhealth.com/homehealthpro

• AHCC Member Survey: https://www.surveymonkey.com/r/7SKBX2J

• Download the slides from this episode: https://ahcc.decisionhealth.com/ahcc-talk-episode-83-fy2026-coding-update/

Questions, topic requests, or guest suggestions? Email Jan Milliman: jan.milliman@decisionhealth.com

🎧 If you found this episode helpful, follow AHCC Talk and share it with your team!

Get clarity on the latest CMS OASIS updates—straight from the experts.

In this episode of AHCC Talk, Jan Milliman and Lisa McClemmy break down the July 2025 CMS OASIS Quarterly Q&As, offering practical guidance on comprehensive assessment, OASIS data set items, and documentation for skilled services. You’ll also hear scenario discussions, a product spotlight, and the latest updates from AHCC.

Resources Mentioned:
📄 July 2025 CMS Quarterly Q&As
🎓 Start your 14-day free trial of Home Health Coding Center
👥 Learn more about AHCC membership
⬇️ Download slides from this episode