CY 2025 Home Health Final Rule Finalizes Payment Reduction, New OASIS Items, Changes to CoPs and More

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) final rule, which updates Medicare payment policies and rates for Home Health Agencies (HHAs). The Final Rule contains changes and updates including the following:

  • Finalizes a permanent prospective adjustment of -1.975% (half of the calculated permanent adjustment of -3.95%) to the CY 2025 home health payment rate to account for the impact of implementing the Patient-Driven Groupings Model (PDGM).

  • CMS is finalizing updates to the HHA CoPs to reduce avoidable care delays by helping ensure that referring entities and prospective patients can select the most appropriate HHA based on their care needs.

  • CMS is finalizing four new items as standardized patient assessment data elements in the social determinants of health (SDOH) category and modifying one item collected as a standardized patient assessment data element in the SDOH category, beginning with the CY 2027 HH QRP via the OASIS.

  • Request for Information (RFI) on Future Performance Measure Concepts for the Expanded HHVBP Model

    This final rule summarizes comments received on a summary of responses to RFI that will build on input from the Expanded Home Health Value-Based Purchasing (HHVBP) Model’s Implementation and Monitoring technical expert panel (TEP).

  • CMS is including an update on health equity, affirming our commitment to meaningfully advance health equity in the expanded HHVBP Model.

  • CMS is adding providers and suppliers that are reactivating their Medicare billing privileges to the categories of new providers and suppliers subject to a provisional period of enhanced oversight (PPEO).

For full details, please visit the CY 2025 Final Rule Fact Sheet on the cms.gov website.

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Based in Chattanooga, TN, HealthCare Strategies (HCS) was founded in 1998 with the belief that high-quality software, consulting and outsourcing services could be provided within the budgetary constraints of most home health and hospice agencies. HCS provides a wide range of products and services to our partner-clients across the United States. Ask about our EMR software platform, HCS Connect™ today!

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