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Estimate the Medicare payment reduction when a Notice of Admission is accepted after the 5-calendar-day window. Reduction = days from admission to NOA acceptance, divided by 30.
Last reviewed June 15, 2026.
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When an NOA is not accepted within 5 calendar days of the home health admission date, Medicare reduces the payment for the period of care by the number of days from the admission date to the date the NOA is submitted and accepted, divided by 30. No LUPA per-visit payments are made for visits on days before the NOA is submitted. Delays caused by Medicare system issues may qualify for an exception. This tool models the basic days ÷ 30 reduction only and is illustrative.
Source CMS Medicare Claims Processing Manual, Chapter 10 (NOA timely filing, days ÷ 30 reduction): cms.gov/.../clm104c10.pdf
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