Home health agencies will see a rate cut in 2026, but it will be significantly less than CMS had initially proposed, according to the Home Health Prospective Payment System final rule released late Friday, Nov. 28, 2025.
 
CMS finalized a national 1.3% decrease in the aggregate. That includes:
  • A 2.4% increase to account for rising agency costs.
  • A 0.9% decrease as a permanent payment adjustment to account for perceived industry changes under the Patient-Driven Groupings Model (PDGM).
  • A 2.7% decrease as a one-time temporary adjustment to begin collecting on perceived overpayments in the years since PDGM was implemented.
Final agency-level payment changes will be dependent on wage index updates in particular census regions and may be more or less than the national average. CMS had proposed a 6.4% payment cut in the proposed rule released in June.
 
The final rule also:
  • Changes the regulations for face-to-face encounters for community referrals, allowing physicians, in addition to NPs, CNSs and PAs, to perform the face-to-face encounter regardless of whether they are the certifying practitioner.
  • Removes the COVID-19 vaccine question from quality reporting beginning with 2026 results. CMS will remove the question with the updated OASIS-E2, expected to be released in April 2026. They will also remove four questions that had been previously set to be added to the OASIS regarding housing, utilities and food insecurity.
  • Updates the HHCAHPS patient survey with fewer, easier-to-understand questions focused on the agency’s performance, effective in April 2026. The changes will require the removal of three of the current measures used for the Patient Survey Star Rating.
  • Adds four new measures to Home Health Value-Based Purchasing (HHVBP) performance scores used to determine payment adjustments. This includes the addition of three new OASIS measures around bathing and dressing and one new claims-based measure, Medicare Spending Per Beneficiary. Three of the HHCAHPS measures will removed to account for the updated survey questions.
Look for more breaking news coverage on the final rule at Home Health Line.