CMS has finalized the CY 2027 Home Health Prospective Payment System (HH PPS) rule. Among the key updates are a 2.4% payment increase, revised OASIS submission deadlines under the Home Health Quality Reporting Program (HH QRP), and stricter Medicare enrollment requirements.
Here’s a quick look at the key changes and what they mean for home health agencies:
1. Medicare Home Health Payments Are Expected to Increase by 2.4% in 2027
CMS projects a 2.4% aggregate increase in Medicare payments to home health agencies, equivalent to approximately $415 million in additional payments industry-wide compared to 2026.
This does not mean every agency will receive a 2.4% increase in reimbursement. The estimate reflects the combined impact of several payment adjustments:
- 2.1% annual payment update: Based on a 3.1% increase in the home health market basket (reflecting the rising costs of providing services), minus a 1.0% productivity adjustment.
- 0.3% increase: Resulting from an adjustment to the Fixed Dollar Loss (FDL) ratio, which affects outlier payments for certain high-cost patients.
An agency’s actual reimbursement change may vary depending on its patient mix, geographic wage adjustments, and utilization of services.
2. Updated OASIS Submission Requirements Under the HH QRP
Beginning in Calendar Year (CY) 2027, CMS will require home health agencies to submit their OASIS assessment data and make any necessary corrections no later than the 15th day of the second month following the end of each calendar quarter.
If the deadline falls on a Friday, weekend, or federal holiday, it will be moved to the next business day.
The following are the finalized deadlines for OASIS data collected in 2027, which will be used for the CY 2029 payment determination:
| Reporting period | OASIS submission deadline |
| Q1: January–March 2027 | May 17, 2027 |
| Q2: April–June 2027 | August 16, 2027 |
| Q3: July–September 2027 | November 15, 2027 |
| Q4: October–December 2027 | February 15, 2028 |
These deadlines apply to the CY 2027 reporting period and will be used for the CY 2029 Annual Payment Update (APU) determination.
What This Means for Agencies
Agencies will need to be more proactive in managing their OASIS completion, review, and submission processes. Delays in completing assessments, resolving errors, or submitting data may affect their ability to meet the new deadlines.
Additionally, CMS is moving toward using a full calendar year of OASIS and HHCAHPS data (January 1 through December 31) for APU reporting. Beginning January 1, 2027, OASIS data from eligible non-Medicare and non-Medicaid patients will also be included in the APU calculation, based on the patient’s SOC M0090 date.
Failure to meet HH QRP reporting requirements can result in a 2-percentage-point reduction in the applicable annual payment update.
3. Revised HHQRP OASIS and HHCAHPS Annual Payment Update (APU) Reporting Periods
CMS is changing the data reporting period used to determine whether an agency meets the Home Health Quality Reporting Program (HHQRP) requirements for its Annual Payment Update (APU).
Previously, the reporting period followed a July 1 through June 30 cycle. CMS will transition to a calendar-year reporting period (January 1 through December 31), beginning with the 2028 APU.
To accommodate this transition, the reporting period for the 2028 APU will be shortened. The transition will differ slightly between OASIS and HHCAHPS data:
OASIS Reporting Period
- 2028 APU: Based on six months of OASIS data, covering July 1 through December 31, 2026.
- 2029 APU onward: Based on a full calendar year of OASIS data, starting January 1 through December 31, 2027.
HHCAHPS Reporting Period
- 2028 APU: Based on nine months of HHCAHPS data, covering April 1 through December 31, 2026.
- 2029 APU onward: Based on a full calendar year of HHCAHPS data, starting January 1 through December 31, 2027.
In short, CMS is aligning both reporting periods with the calendar year. The 2028 APU will serve as the transition period, while the 2029 APU will be the first to use a full calendar-year reporting cycle for both data types.
4. Changes to Medicare Provider Enrollment Requirements
CMS is introducing stricter enrollment rules to strengthen program integrity and prevent fraud, waste, and improper Medicare payments.
Some important changes include:
- Retroactive revocations: CMS may make Medicare enrollment revocations effective retroactively to the date a provider’s noncompliance began.
- Changes in majority ownership: Home health agencies experiencing certain changes in majority ownership may be required to enroll again as a new provider and undergo a new survey or accreditation.
- Expanded grounds for denial or revocation: Enrollment may be denied or revoked based on certain licensing or program suspensions involving not only the provider but also its owners and managing employees or organizations.
These changes make it increasingly important for agencies to maintain proper licensing, ownership records, and ongoing compliance with Medicare enrollment requirements.
5. Other key updates
Effective April 1, 2027, CMS is expanding the Medicare Part B Durable Medical Equipment (DME) benefit to cover certain external infusion pumps and associated home infusion drugs.
CMS also acknowledged the role home health agencies can play in providing community-based palliative care to patients with serious or progressive illnesses.
Although the rule does not establish a separate new palliative care benefit, CMS indicated that it will provide examples of qualifying services through future guidance.
With these changes coming in 2027, home health agencies should take time to review the updates and see how they may affect their current processes. Staying informed and preparing early can help agencies keep up with CMS requirements, avoid reporting issues, and maintain smooth day-to-day operations.
For a closer look at all the changes, read the full CMS Fact Sheet on the CY 2027 Home Health Prospective Payment System Final Rule>
