CMS CY 2026 Home Health Proposed Rule: What You Need to Know
The Centers for Medicare & Medicaid Services (CMS) has released the Calendar Year (CY) 2026 Home Health Proposed Rule, bringing significant changes to the industry. This high-level overview highlights the key updates that could impact home health agencies nationwide. Register now for our complimentary webinar on July 8th at 12 EST!
Read the full proposed rule fact sheet now.
The proposed rule outlines a 6.4% aggregate reduction in Medicare payments for 2026, equating to a $1.135 billion decrease compared to 2025. This cut includes a 2.4% payment update offset by various adjustments, including a permanent -4.059% reduction and a one-time -5.0% temporary adjustment to address past overpayments. According to the CMS fact sheet, these changes aim to align payments with patient care needs under the Patient-Driven Groupings Model (PDGM) while ensuring program sustainability.
Home Health Care News (HHCN) reported on June 30, 2025, that industry leaders, including the National Alliance for Care at Home, are concerned this cut could limit access to care, with Dr. Steve Landers stating, “CMS has failed not just our providers, but the millions of Americans who depend on home health services.”
The rule also proposes updates to PDGM case-mix weights, face-to-face encounter policies, and the Home Health Value-Based Purchasing (HHVBP) model.
COMPLIMENTARY WEBINAR Tuesday July 8th
Join us Tuesday July 8th at 12 pm EST for a complimentary webinar hosted by SimiTree’s Brian Harris, VP of Financial Consulting, and J’non Griffin, RN, MHA, HCS-D, HCS-C, HCS-H, HCS-O, COS-C, Senior Vice President, Coding & OASIS. REGISTER NOW
For more details on the proposed rule, visit the Federal Register.
For additional information about the Home Health Prospective Payment System, visit: https://www.cms.gov/medicare/medicare-fee-for-service-payment/homehealthpps and https://www.cms.gov/Center/Provider-Type/Home-Health-Agency-HHA-Center.