The Medicare Claims Processing Manual which was released May 11th states that the Notice of Admission (NOA) will be submitted just once to establish the agency as the primary provider. That will cover all continuous 30-day periods until discharge. Therefore, starting January 1, 2022, agencies will no longer submit RAPs.

Prior to submitting the Notice of Admission (NOA) the agency must have received a verbal or written order from the physician that contains services required for the initial visit. The agency must also have conducted the initial Start of Care visit.

The Notice of Admission will need to be approved within 5 calendar days of the SOC so it should be submitted prior to day 5. There will be a late penalty of 1/30th of the payment for each day past the SOC date.