CMS: Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies

Federal Register

Dec 2, 2025

Notice of a final rule from the Centers for Medicare & Medicaid Services (CMS) updating the home health payment rates for calendar year (CY) 2026. This rule also finalizes changes to the face-to-face encounter policy, Home Health Quality Reporting Program (HH QRP), and the expanded Health Value-Based Purchasing (HHVBP) Model requirements; updates the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP); and makes a technical change to the home health conditions of participation. Among other things, this rule also finalizes permanent and temporary behavior adjustments and recalibrates the case-mix weights and update the functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2026. These regulations are effective January 1, 2026.

Healthcare business and finance · Healthcare quality · Home health · Legislation and regulations · Medicare · Post-acute care · Reimbursement and payment models