PEP (Partial Episode Payment)
A Partial Episode Payment (PEP) adjustment prorates a 30-day payment period when the period ends early because the patient transferred to another home health agency, or was discharged with goals met and then readmitted to home health, within the same 30 days. The agency is paid for the portion of the period it was responsible for rather than the full case-mix amount.
Definition
A Partial Episode Payment (PEP) adjustment prorates a 30-day payment period when the period ends early because the patient transferred to another home health agency, or was discharged with goals met and then readmitted to home health, within the same 30 days. The agency is paid for the portion of the period it was responsible for rather than the full case-mix amount.
Why it matters
PEP (Partial Episode Payment) is part of the Revenue Cycle & Billing vocabulary used across home health operations, documentation, and revenue cycle. Understanding it helps clinicians, QA leads, and administrators stay aligned on care quality and compliance.
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