California is next for the Review Choice Demonstration (RCD). On November 2, 2026, CMS announced plans to expand RCD to California home health agencies. In this breaking-news episode of Home Health Revealed, Hannah Vale, CEO of HealthRev Partners, explains what the change means and how agencies can prepare before the selection window closes.
California agencies bill through Jurisdiction 6, now served by Wellpoint Federal. The selection period runs from November 16 to December 16, 2026, and the demonstration is set to start for billing periods on or after January 18, 2027, pending OMB approval. Agencies in Illinois, Ohio, Texas, North Carolina, Florida, and Oklahoma have already been through RCD with Palmetto GBA (Jurisdiction M). For California, this conversation needs to happen now.
Hannah covers:
- What RCD is: the Medicare home health benefit stays the same, but the level of review rises
- Option 1, pre-claim review: documentation goes to the contractor before the final claim, and an affirmed request gets a unique tracking number (UTN)
- Option 2, postpayment review: claims are paid and then may be selected for ADRs. Agencies that make no selection default to this option.
- How a 90% or higher full affirmation rate (on at least 10 requests in a 6-month period) can lead to less intensive review options
- Why every document in a packet has to tell one consistent story: diagnosis, face-to-face, homebound status, skilled need, plan of care, and orders
- The operational questions: who pulls, reviews, submits, and tracks each request, and who follows up on non-affirmations
- Three questions to ask now: Do we have a defined process? Do we have the people and capacity? Do we have the technology and reporting?
- Why California agencies can’t bundle billing periods: plan for one request per 30-day billing period
Read the full California RCD guide and download the free RCD pre-claim review checklist: https://healthrevpartners.com/resource-center/blog/home-health-review-choice-demonstration-california/
Watch on YouTube: https://youtu.be/WdXUHBOe8xg
Need a partner for pre-claim review, coding, OASIS review, or billing? HealthRev Partners works with agencies in RCD states every day: https://healthrevpartners.com/
Timestamps:
00:00 Intro: Home Health Revealed
00:20 California is next for RCD
01:24 What CMS announced, and the key dates
02:42 What RCD is, and what it doesn’t change
04:09 Why RCD is an operational issue, not just a billing issue
04:32 Option 1: Pre-claim review (PCR) and the UTN
05:49 Option 2: Postpayment review, and the default if you don’t choose
06:44 The 90% affirmation path to lighter review
07:17 The added workload and staff capacity
08:04 The biggest challenge: documentation that tells one story
09:05 What goes into a pre-claim review packet
10:51 The operational impact: who owns each step?
12:01 Three questions every California agency should ask
13:38 Postpayment review still needs a disciplined process
14:12 How HealthRev Partners helps
16:20 Technology helps, but experts make the call
16:43 What I would do as a California agency leader
18:55 No bundling in California: one request per 30-day period
19:12 Final thought: build a stronger organization
20:58 Wrap-up: the clock is ticking
