The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has added a new home health review to its Work Plan, signaling increased scrutiny of how agencies bill single-discipline visit units.

The new review stems from past OIG findings that Medicare Administrative Contractors (MACs) issued incorrect outlier payments when visit units were billed inaccurately. To assess nationwide billing accuracy, the OIG will evaluate single-discipline visits billed for more than four hours to determine whether those claims meet Medicare’s requirements.

A key benchmark highlighted by the OIG: the national average home health visit lasts approximately 45 minutes, based on an analysis of 30 months of claims data. Any visit billed far above that standard—particularly those exceeding four hours — may be subject to review.

Agencies should expect heightened attention on documentation that substantiates the duration and clinical need for extended visits. Accurate time-tracking, clear clinical justification, and internal auditing will be essential to defend claims selected for review. With the OIG planning to complete this work in 2027, providers should anticipate ongoing monitoring of billing patterns over the next two years.

The official Work Plan item is available on the OIG website here.

HCAF will continue tracking developments and supporting Florida home health agencies with the guidance and resources needed to maintain compliance and protect revenue integrity.