Data / Federal rules / 2025-12347
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
The Centers for Medicare & Medicaid Services published this proposed rule in the Federal Register on July 2, 2025. Comments closed on August 29, 2025.
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What the agency says
This proposed rule would set forth routine updates to the Medicare home health payment rates in accordance with existing statutory and regulatory requirements. In addition, this proposed rule proposes permanent and temporary behavior adjustments and proposes to recalibrate the case-mix weights and update the functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2026. Lastly, this proposed rule proposes policy changes to the face-to-face encounter policy. It also proposes changes to the Home Health Quality Reporting Program (HH QRP) and the expanded Health Value-Based Purchasing (HHVBP) Model requirements. In addition, it would update the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). Lastly it proposes: a technical change to the HH conditions of participation; updates to DMEPOS supplier conditions of payment; updates to provider and supplier enrollment requirements; and changes to DMEPOS accreditation requirements.
Key facts
- Document number
- 2025-12347
- Type
- Proposed rule
- Action
- Proposed rule
- Agency
- Health and Human Services Department; Centers for Medicare & Medicaid Services
- Published
- July 2, 2025
- Comments due
- August 29, 2025
- Dates
- To be assured consideration, comments must be received at one of the addresses provided in the ADDRESSES section, no later than 5 p.m. EDT on September 2, 2025.
- Docket
- CMS-1828-P
- Regulation ID (RIN)
- 0938-AV53
- Code of Federal Regulations
- 42 CFR 405; 42 CFR 414; 42 CFR 424; 42 CFR 455; 42 CFR 484; 42 CFR 498
- Topics
- Administrative practice and procedure; Biologics; Diseases; Drugs; Emergency medical services; Fraud; Grant programs-health; Health facilities; Health professions; Investigations; Medicaid; Medical devices; Medicare; Reporting and recordkeeping requirements; Rural areas; X-rays
- Significant
- Yes, under Executive Order 12866
- Pages
- 232
Other documents from the Centers for Medicare & Medicaid Services
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