HH RCD North Carolina and Florida Transition to Cycle 9

Published 10/17/2025

As the Review Choice Demonstration (RCD) for home health agencies (HHA) in North Carolina and Florida continues, the time for Cycle 9 is approaching.

If an HHA's full affirmation rate or claim approval rate is 90 percent or greater for the previous six-month period, the provider may choose one of the subsequent review options:

  • Choice 1: Start or continue participating in pre-claim review (PCR) for another cycle
  • Choice 3: Selective postpayment review of a statistically valid random sample (SVRS) of claims every six months for the remainder of the demonstration
  • Choice 4: Spot Check Review of five percent of claims every six months to ensure continued compliance

Note: If an HHA is eligible for a subsequent review option but does not make a selection during the selection period, the HHA will be placed in Choice 3.

If an HHA’s full affirmation rate is less than 90 percent for the previous six-month period, it may choose one of the initial review options:

  • Choice 1: Start or continue participating in PCR for another cycle
  • Choice 2: 100 percent postpayment review

Note: If an HHA is eligible for an initial review option, but does not make a selection during the selection period, the HHA will be placed in Choice 2.

For those options that are evaluated every six months, the claims or PCR requests reviewed during the cycle will determine the provider’s results. Providers will continue in their selected option during the calculation and selection period. The affirmation rate calculation period occurs during the month of November 2025, with result letters being sent to HHAs by the end of November 2025. The selection period for Cycle 9 will take place from December 1, 2025, through December 14, 2025. HHAs that do not make a selection during that time period will default to either Choice 2 or Choice 3 as noted earlier in this article.

Transition Timeline

Table 1: Transition Timeline
  Cycle 6 Cycle 7 Cycle 8 Cycle 9 Cycle 10 Cycle 11 Cycle 12
Cycle Start

01/01/24

09/01/24

05/01/25

01/01/26

09/01/26

05/01/27

01/01/28
Cycle End

06/30/24

02/28/25

10/31/25

06/30/26

02/28/27

10/31/27

06/30/28
Results Posted

07/31/24

03/31/25

11/30/25

07/31/26

03/31/27

11/30/27

07/31/28
Selection Start

08/01/24

04/01/25

12/01/25

08/01/26

04/01/27

12/01/27

08/01/28
Selection End

08/14/24

04/14/25

12/14/25

08/16/26

04/14/27

12/14/27

08/14/28

As providers transition from Cycle 8 to Cycle 9, please be advised of the actions required when changing from one choice to another.

Important Notes

  • Any claim with a date of service on or after 8/31/2020 is subject to the RCD program in North Carolina and Florida
  • If your selection changes, remember that the date of submission determines which RCD selection applies to your claims, not the dates of service
Table 2
If Your
Cycle 8
Choice was:		 And Your Cycle 9 Choice is: Here are the actions you will need to take:
Choice 1: PCR Choice 1: PCR 1. Continue PCR process. Data from November and December will be included in the Cycle 9 results.
Choice 1: PCR Choice 2: Postpayment Review

1. Continue to submit PCR requests through 12/31/2025. Data from November and December will be included in the Cycle 9 results.

  1. Add UTN to claims if PCR was submitted (regardless if affirmed or non-affirmed)
  2. Respond to ADRs as generated

2. As of 1/1/2026, submit final claim.

  1. Final bill will adjust, and the ADR will generate
  2. Respond to ADR
Choice 1: PCR Choice 3: Selective Postpayment Review

1. Continue to submit PCR requests through 12/31/2025. Data from November and December will be included in the Cycle 9 results.

  1. Add UTN to claims if PCR was submitted (regardless if affirmed or non-affirmed)
  2. Respond to ADRs as generated

2. As of 1/1/2026, submit final claim for payment.

  1. Final bill will be adjusted, and the ADR will generate
  2. Respond to ADR
Choice 1: PCR Choice 4: Spot Check

1. Continue to submit PCR requests through 12/31/2025. Data from November and December will be included in the Cycle 9 results.

  1. Add UTN to claims if PCR was submitted (regardless if affirmed or non-affirmed)
  2. Respond to ADRs as generated

2. As of 1/1/2026, submit final claim.

  1. ADR will generate
  2. Respond to ADR
Choice 2: Post Payment Review Choice 1: PCR

1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 9 results.

2. Begin submitting PCR requests on 1/1/2026 for any claim that will be submitted on or after 1/1/2026 with a date of service on or after 8/31/2020.

  1. Add UTN to claims with PCR requests
Choice 2: Postpayment Review Choice 2: Postpayment Review 1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 9 results. 
Choice 2: Postpayment Review Choice 3: Selective Postpayment Review 1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 9 results. 
Choice 2: Postpayment Review Choice 4: Spot Check 1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 9 results. 
Choice 4: Spot Check Choice 1: PCR

1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 9 results. 

2. Begin submitting PCR requests on 1/1/2026 for any claim that will be submitted on or after 1/1/2026 with a date of service on or after 8/31/2020.

  1. Add UTN to claims for claims with PCR requests
Choice 4: Spot Check Choice 2: Postpayment Review 1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 9 results.
Choice 4: Spot Check Choice 3: Selective Postpayment Review 1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 9 results. 
Choice 4: Spot Check Choice 4: Spot Check 1. Continue to respond to ADRs. Data from November and December will be included in the Cycle 9 results. 

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