Home Health Notice of Admission Fix: What CMS's New Change Request Means for Long Stays

CMS has issued a quiet but useful fix for the home health Notice of Admission process. Change Request 14605, released October 8 as Transmittal 13996, addresses claims that come back with reason code 19963, "Notice of Admission not found," even though the agency filed its NOA correctly. The problem shows up on long admissions: when a claim's service dates fall within 24 months of the admission date but the claim itself arrives after that 24-month mark, the original NOA record may already have been purged from Medicare's claims processing system.

Why the home health Notice of Admission record goes missing

Medicare matches each home health claim to its NOA to find the NOA receipt date, which is also how any late NOA adjustment gets applied. That stored record is periodically cleared out of older data. CMS tried to close this gap once before with Change Request 13684 in 2024, which covered claims whose dates stretched past 24 months. MACs then reported the remaining case, where every date of service sits inside the window but the claim is received late. Under the new instruction, the contractor will accept those claims and use the admission date as the receipt date. CMS says the change carries no new policy. It is effective April 1, 2027, with implementation on April 5, 2027.

For most agencies this will touch a small number of claims, but they tend to be the frustrating kind: long-term patients, adjusted or late claims, and corrections that come up well after the original episode. LeadingAge flagged the fix for members on October 15, and McKnight's Home Care noted it in its October 19 briefs. Until the fix is in production, a 19963 return on an older admission may simply mean the record aged out, not that your team skipped a step.

What to do between now and April 2027

The practical move is to keep your own proof. For each admission, have the NOA submission and acceptance dates somewhere your billing team can find them in seconds, along with the admission date. Flag patients whose admissions are getting close to the 24-month mark, so any late or corrected claims get extra attention before they go out. If a 19963 return does show up, check it against your records first and talk to your MAC with those dates in hand rather than refiling blind.

This is the same habit that pays off across most billing questions: a clean, dated record of what was planned, what happened and what was submitted. That is the kind of visit verification visibility we build into CareSync® for home care teams. Whatever system you use, the agencies that can answer "when did we file that?" without digging through inboxes are the ones that spend the least time on rework.