Data / Federal rules / 2025-21767
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 final rule in the Federal Register on December 2, 2025. It took effect on January 1, 2026.
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What the agency says
This final rule sets forth routine updates to the Medicare home health payment rates in accordance with existing statutory and regulatory requirements. In addition, this final rule 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. This final rule also finalizes changes to the face-to-face encounter policy and changes to the Home Health Quality Reporting Program (HH QRP) and the expanded Health Value-Based Purchasing (HHVBP) Model requirements. In addition, it updates the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). Lastly it finalizes: 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
- 2025-21767
- Type
- Final rule
- Action
- Final rule
- Agency
- Health and Human Services Department; Centers for Medicare & Medicaid Services
- Published
- December 2, 2025
- Takes effect
- January 1, 2026
- Dates
- These regulations are effective on January 1, 2026.
- Docket
- CMS-1828-F
- 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
- 279
Other documents from the Centers for Medicare & Medicaid Services
Everything from the Centers for Medicare & Medicaid Services · Rules on administrative practice and procedure · Rules on biologics · Rules on diseases · Published in December 2025
Read from the Federal Register API, last updated 2026-10-23. The document on federalregister.gov is the official record; dates and dockets can change through later corrections. Free to reuse with credit to SpecStream under CC BY 4.0.