Comprehensive outpatient rehabilitation facility services bundled to home agency (Updated for 2026)

Common Causes for 102

Denials with code 102 typically happen for the following specific reasons:

• The patient was actively receiving home health services under an open 60-day home health episode of care at the time CORF services were rendered.
• The CORF failed to perform a pre-service eligibility check in the Common Working File (CWF) to identify an active Home Health Agency (HHA) plan of care.
• A lack of communication or formal contract between the CORF and the HHA to bill the HHA directly under a 'under arrangement' agreement.
• The Home Health Agency failed to submit a timely discharge claim or notice to close the active home health episode in the Medicare system.

How to Prevent 102 Denials

To avoid receiving this denial in the future, implement these specific checks:

• Implement a mandatory pre-admission eligibility screening process utilizing the HIPAA Eligibility Transaction System (HETS) to check for open HHA episodes before initiating CORF services.
• Incorporate specific questions regarding current or recent home health, nursing, or home-based therapy services into the patient intake and registration forms.
• Establish a written contract with the Home Health Agency to bill them directly for physical, occupational, or speech therapy services if the patient must remain on home health.
• Coordinate directly with the patient's HHA to ensure they submit their discharge claim (Type of Bill 329) promptly to free up the Medicare Common Working File for outpatient billing.

Appeal Letter Template for 102

If you believe this claim was denied incorrectly, you can use the following template to submit an appeal.

[Your Practice Header]
[Date]

[Payer Name]
[Appeals Department Address]

RE: Appeal for Claim [Claim Number]
Patient: [Patient Name]
ID: [Patient ID]
Date of Service: [Date]
Denial Code: 102 - Comprehensive outpatient rehabilitation facility services bundled to home agency

Dear Appeals Department,

I am writing to appeal the denial of the above-referenced claim, which was denied with code 102: "Comprehensive outpatient rehabilitation facility services bundled to home agency".

We are appealing the denial of the enclosed claim for Comprehensive Outpatient Rehabilitation Facility (CORF) services under denial code 102. Pursuant to the Medicare Benefit Policy Manual, Chapter 10 and Chapter 12, home health consolidated billing rules only apply when a patient is under an active, certified Home Health Plan of Care (POC). Our records and the attached clinical documentation demonstrate that the patient was formally discharged from all home health services by [HHA Name] on [Discharge Date], which is prior to the dates of service rendered by our facility on [Service Date]. Because the patient was no longer under an active HHA Plan of Care during our treatment window, these CORF services are eligible for independent Medicare Part B reimbursement. We respectfully request that you review the attached discharge summary, update the CWF, and reprocess this claim for immediate payment.

Attached please find:
1. A copy of the original claim.
2. The relevant medical records supporting the service.
3. [Any other supporting documents].

We respectfully request that you reprocess this claim for payment.

Sincerely,

[Your Name]
[Title]
[Practice Name]