Claim HHA Low Utilization Payment Adjustment (LUPA) Indicator Code

SAS Name

The code used to identify those Home Health PPS claims that have 4 visits or less in a 60-day episode.

If an HHA provides 4 visits or less, they will be reimbursed based on a national standardized per visit rate instead of Home Health resource groups (HHRGs).


Beginning 10/1/00, this field was populated with data. Claims processed prior to 10/1/00 contained spaces. 

Source: NCH

Code Code value
L Low utilization payment adjustment (LUPA) claim
BLANK Not a LUPA claim; process using Home Health resource groups (HHRG)