NOA and Billing Resources

The following success resources are designed to help organizations accommodate NOAs and billing changes in 2022.

Software Updates

Click the link below to view recent software updates designed to accommodate NOAs and billing changes in 2022.

Notice of Admission (NOA)


Click to find answers to frequently asked questions on NOA requirements.


NOA RTP Reason Code 32114

Your organization may be impacted by a CMS oversight that is currently causing NOAs to be rejected for missing ZIP codes (reason code 32114). CMS is aware of this issue and is actively working toward a resolution.

To rectify this error:

Step 1: Verify that your DDE (black screen) logins are active by clicking the blue DDE Black Screen button in the top-right corner of Axxess DDE.

Step 2: Access the claim in the Claim Center, enter the 9-digit ZIP code and resubmit the claim (F9).

Since this issue is only affecting batch claims, you can manually enter NOAs into DDE (black screen) to ensure pending acceptance.

If an NOA is late due to this issue, enter the following text in the Remarks section of your final claim: Jan 2022 Issue RE 32114.

To track the latest claim issues identified by CMS, visit the following links:

Palmetto GBA:


For more information, CGS Medicare has provided a job aid document with additional details on billing the home health NOA.

NOA RTP Reason Code 19960

Your organization may be impacted by an issue causing NOAs to return to providers with reason code 19960 in status/location TB9900 and condition code 15.

Palmetto is actively working to resolve this issue. For most NOAs that were affected, Palmetto removed condition code 15 and reason code 19960 prior to the NOA returning to the provider. This allowed many NOAs to process without returning to the provider for this issue and affecting the received date.

Some NOAs may still return to the provider and be in status/location TB9997. Palmetto is reviewing these NOAs for resolution. No provider action is required at this time.

If an NOA is late due to this issue, providers must request a late NOA exception on the corresponding claim. In the Remarks section of your exception request, enter: Late due to CC 15 release.

NOA RTP Reason Code U537F

Palmetto GBA has identified an issue where reason code U537F is assigning incorrectly on some NOAs due to the Common Working File (CWF) not correctly recognizing discharges. A resolution to this issue is being created, but an implementation date has not been established.

Organizations should closely review reason code U537F, as some NOAs may be correctly editing for this reason code. Organizations should ensure that the claim does not have an open home health episode on file from a different organization, regardless of billing period date. If the previous organization has not closed billing (DOLBA is blank), your organization’s NOA should include condition code 47.

Another instance in which providers will see NOAs in Return to Provider (RTP) status is when duplicate NOAs are submitted. In this scenario, one of the duplicate NOAs will be returned with reason code U537F. The other will continue to process for approval or edit for other reasons, if applicable. In this instance, the NOA marked with U537F should be suppressed by the provider and no further action is required.


Overview of the 2022 Home Health Final Rule Changes

This recorded webinar provides an overview of the most important Medicare home health Final Rule regulations, including those going into effect on January 1, 2022. Watch to learn more about the following major changes:

  • Value-based purchasing expansion and payment rate changes

  • New Notice of Admission requirements and late submission penalties

  • COVID-19 updates, including the continuation of virtual visits and initial assessments by occupational therapists

  • Home Health Quality Reporting updates and the start of OASIS-E

Download the Slides

Home Health Value-Based Purchasing: Lessons Learned and Recommendations

As Medicare expands its value-based purchasing (VBP) and value-based insurance design (VBID) models, home health and hospice organizations must ensure high-quality, cost-effective care. In this video, Axxess’ Deborah Hoyt speaks with industry leaders Thom Mills, board president of the Tennessee Association of Home Care and administrator of Quality Home Health; and Joe Russell, executive director of the Ohio Council for Home Care and Hospice. Among topics discussed:

  • Lessons learned from an organization that successfully managed the transition to VBP

  • Clinical and operational considerations to gain maximum reimbursements and ensure long-term sustainability

  • The importance of using data and technology in designing quality improvement programs

Home Health NOA: Regulation and Axxess Solution Updates

This training video provides a short recap of the major regulatory changes, as well as a walkthrough of the Axxess Home Health solution updates that will help organizations remain compliant. Axxess’ Christina Andrews, director of professional services, and Sophia Saldivar, home health product manager, cover:

  • The purpose, submission process and requirements of the NOA

  • A demo of the new NOA features in the Axxess solution

  • Available support and resources to learn more

Download the Slides

Live Q&A on Home Health Medicare Billing

Axxess Home Health billing experts Sophia Saldivar and Betsy Thomas share how to best execute operational changes to succeed in the 2022 Medicare billing environment. Watch this video to understand:

  • Strategies to successfully handle common scenarios and issues related to the NOA changes

  • Best practices on using Axxess solutions to stay on top of claim requirements and assess the financial impact to your organization

  • Answers to audience-submitted financial questions about important and upcoming Medicare regulations

Download the Slides


Click the links below to read Axxess blogs on NOAs and billing changes in 2022.

NOA Lessons Learned – Three Acceptance Issues and How to Fix Them

What Is the NOA and How Will It Affect You?

How to Improve a QAPI Program for Value-Based Purchasing Success

QAPI Is the Key to Value-Based Purchasing

Home Health Coding Updates You Should Know

Axxess User Community

Visit the Axxess User Community to ask questions, find answers and connect with other Axxess users.

Axxess User Community