The U.S. Centers for Medicare & Medicaid Services (CMS) released the CY 2026 Home Health Final Payment Rule on November 28. We have summarized the key changes home health agencies should be ready for in 2026.
Medicare Payment Update
CMS projects that Medicare aggregate payments to home health agencies will decrease by 1.3% (about $220 million) compared to 2025.
How CMS arrived at the 1.3% decrease:
CMS applies multiple annual adjustments—such as the home health payment update, budget neutrality factors, and changes tied to the Patient-Driven Groupings Model (PDGM). When these adjustments are combined, the net result is a 1.3% reduction in total Medicare payments for 2026.
Face-to-Face Encounter Flexibility
CMS is finalizing a change to the face-to-face (F2F) requirements to expand flexibility for agencies and reduce barriers to timely F2F completion.
- Physicians, along with NPs, CNSs, and PAs, may now perform the F2F encounter.
- The F2F encounter may be completed by a practitioner, even if they are not the certifying practitioner.
- The practitioner does not need to have treated the patient in the hospital or post-acute facility prior to the home health admission.
HHQRP Changes for CY 2026
- Removal of the COVID-19 Vaccine Measure & O0350
- The measure “COVID-19 Vaccine: Percentage of Patients Who Are Up to Date” is being removed from HHQRP.
- OASIS item O0350 will be removed starting April 1, 2026.
- Until then, HHAs may submit any valid response (0, 1, or dash) without affecting quality measures.
- Removal of Certain SDOH OASIS Items
- 4 Social Determinants of Health items—related to living situation, food access, and utilities—will be removed. These items were originally set for collection in 2027, so they are being eliminated before data collection ever begins.
- Reconsideration Policy Update
- HHAs may request an extension when filing a reconsideration request about a noncompliance determination if they can show the agency was affected by an extraordinary circumstance during the 30-day filing period.
- HHCAHPS Survey Revisions
- Three questions added, eight removed
- Changes take effect April 2026
- Updated Patient Survey Star Rating Methodology
- Five new HHCAHPS-based quality measures added
- Updated weighting will impact the Patient Survey Star Rating calculation
HHVBP Changes for CY 2026
- Removal of Three HHCAHPS-Based Measures
The following survey-based measures will be removed because the revised survey no longer supports their calculation:- Care of Patients
- Communications Between Providers and Patients
- Specific Care Issues
- Addition of Four New Measures
- 1 claims-based measure: MSPB-PAC (Medicare Spending Per Beneficiary – Post-Acute Care) which aims to promote high-quality, cost-efficient care
- 3 OASIS-based measures. These complement the Discharge Function Score and provide a broader picture of functional improvement.
- Improvement in Bathing
- Improvement in Upper Body Dressing
- Improvement in Lower Body Dressing
- Updated Category Weights (for larger-volume HHAs)
- Reduced weight for HHCAHPS survey measures
- Increased weight for claims-based and OASIS-based measures
This shifts more emphasis toward clinical outcomes and resource efficiency.
Home health agencies should keep up with the Final Rule updates to stay compliant, ensure accurate reporting, and maintain operational efficiency. Read the entire CMS Fact Sheet on CY) 2026 Home Health Prospective Payment System Final Rule.
