Home Health PPS
November 21, 2024
AT A GLANCE
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 issued its calendar year (CY) 2025 final rule for the home health (HH) prospective payment system (PPS). New policies will generally be effective Jan. 1, 2024
Key Highlights
The final rule will:
- Increase net HH payments by an estimated 0.5%, or $85 million, after all policy changes, compared to CY 2024. This increase results from a net 2.7% market basket update, a 1.8% downward behavioral adjustment and a 0.4% reduction to outlier payments.
- Adopt new core-based statistical areas (CBSAs) for wage indexes.
- Require HH agencies (HHAs) to report four new patient assessment items in the HH agency Outcome and Assessment Information Set (OASIS) under the social determinants of health category beginning with CY 2027.
- Add a new standard within the Medicare Conditions of Participation (CoP) that will require HHAs to develop, implement and maintain a “patient acceptance to service” policy that is consistently applied to each prospective patient referred for HH care.
- Adopt requirements for long-term care (LTC) facilities to report certain data related to respiratory elements as part of their infection control programs.
View the detailed Regulatory Advisory.
Key Resources
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- CMS Releases CY 2025 Home Health PPS Proposed Rule (June 27, 2024)
- Special Bulletin: CMS Releases CY 2023 Home Health PPS Final Rule (November 1, 2022)
- Regulatory Advisory: Home Health Prospective Payment System Proposed Rule for CY 2023 (July 27, 2022)
- Special Bulletin: CMS Releases CY 2023 Home Health PPS Proposed Rule (June 21, 2022)
- Advisory Home Health PPS Final CY 2022 Rule (Nov. 22, 2021)
- Special Bullen: CMS Issues CY 2022 Final Rule for Home Health Payment System (Nov 3, 2021)
Related Resources
Related Resources
AHA Center for Health Innovation Market Scan
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AHA Center for Health Innovation Market Scan
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