# 2026-22750: Medicare's Home-Health Payment Machinery Gets Its Annual Tune-Up 2026-22750, Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Expanded HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies, is a Federal Register rule from Health and Human Services Department, Centers for Medicare & Medicaid Services published 2026-11-09, effective 2026-01-04; deemed significant under Executive Order 12866; PRIA reads it as touching household money (as of 2026-11-11). - Canonical: https://policyrisk.com/federal-register/2026-22750 - As of: 2026-11-11 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Document number: 2026-22750 - Title: Calendar Year 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Expanded HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies - Type: Rule - Agencies: Health and Human Services Department; Centers for Medicare & Medicaid Services - Citation: 91 FR 72022 - Published: 2026-11-09 - Effective: 2026-01-04 - Comments close: not stated - Significant: yes (OIRA_API) - Touches household money: yes - Regulation identifier numbers: 0938-AV80 - Last updated: 2026-11-11 ## In one line Medicare's Home-Health Payment Machinery Gets Its Annual Tune-Up ## Summary Starting in 2027, Medicare is updating how it pays home health agencies, including new payment rates and rules to make care better and fairer. Home health providers, equipment suppliers, and Medicare enrollees will see changes in payment methods, quality reporting, and equipment rules, with some new deadlines and expanded benefits. These updates aim to improve care quality while keeping payments clear and fair. ## Abstract 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 discusses the behavior adjustments and finalizes a temporary behavior adjustment. It also finalizes the recalibrated case-mix weights and updated functional impairment levels; comorbidity subgroups; and low-utilization payment adjustment (LUPA) thresholds for CY 2027. Additionally, this final rule discusses and responds to comments on the provision of home health palliative care services and includes a summary of comments received on the request for information (RFI) on a home health specific wage index included in the proposed rule. This rule also finalizes changes to the Home Health Quality Reporting Program (HH QRP) and summarizes potential initiatives to improve alignment between the HH QRP and expanded Home Health Value- Based Purchasing (HHVBP) Model. Lastly, the rule clarifies the application of the DMEPOS face-to- face encounter requirements for the replacement of DMEPOS items; makes changes to the provider and supplier enrollment requirements; makes changes to implement a DME benefit expansion for infusion pumps and drugs; and discusses collection of information requirement changes regarding the DMEPOS Competitive Bidding Program (CBP) country of origin. ## Effects PRIA read - CY 2027 Home Health Payment Rate Changes: mixed, high. Starting January 1, 2027, Medicare finalizes updates to the CY 2027 home health payment system, including recalibrated PDGM case-mix weights, updated low-utilization payment adjustment (LUPA) thresholds, new functional impairment levels and comorbidity subgroups, updates to the home health wage ind… - New Quality Reporting Deadlines for HHAs: cost, medium. Beginning with the CY 2027 Home Health Quality Reporting Program (HH QRP), CMS finalizes revised HH QRP data submission deadlines and requires the OASIS and HHCAHPS Annual Payment Update (APU) reporting timeframe to use a calendar year of data (January 1 through December 31). Under existing law cit… - No New Face-to-Face Visit for DME Replacements: benefit, low. CMS finalized that an additional face-to-face encounter will not be required to support payment when ordering replacement DMEPOS items; specifically, an additional face-to-face encounter within the 6 months preceding an order/prescription for replacement items is not required. The rule clarifies th… - Stricter Provider Enrollment and Reapplication Bar: cost, high. CMS finalized additions to the grounds for denying or revoking a provider's or supplier's Medicare enrollment and expanded the reasons CMS can apply a retroactive effective date for revocations. CMS is also expanding the ability to impose a reapplication bar (previously up to 10 years when denial w… - Part B DME Benefit Expanded to Infusion Pumps/Drugs: benefit, medium. CMS finalized a change to the Medicare Part B definition of durable medical equipment at 42 CFR 414.202 to implement section 6222(a) of the Consolidated Appropriations Act, 2026, so that certain external infusion pumps and associated home infusion drugs or other associated supplies are treated as m… - DME Supplier Reporting of Country of Origin: benefit, low. CMS plans to request a revision to its DMEPOS Competitive Bidding Program information collection so that DMEPOS contract suppliers must report the country of origin for lead items furnished during the contract period; the reported country-of-origin information would be displayed in the Medicare Sup… ## Related documents - [2026-22812](https://policyrisk.com/federal-register/2026-22812): Medicare and Medicaid Programs; Cutting Administrative Requirements for Excellence in Patient Care, 2026-11-10 - [2026-22792](https://policyrisk.com/federal-register/2026-22792): Medicare Drug Price Negotiation Program and Medicare Prescription Drug Benefit Program, 2026-11-09 - [2026-22743](https://policyrisk.com/federal-register/2026-22743): Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage…, 2026-11-09 - [2026-22739](https://policyrisk.com/federal-register/2026-22739): Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; i…, 2026-11-06 - [2026-22381](https://policyrisk.com/federal-register/2026-22381): Medicare and Medicaid Programs; Organ Procurement Organizations Conditions for Coverage: Revisions to the Conditions for Coverage, 2026-11-03 - [2026-22194](https://policyrisk.com/federal-register/2026-22194): Medicare Program; CY 2027 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System, Acute Kidney Injury (AKI) Dialysis Paym…, 2026-10-30 ## Sources - [2026-22750 on federalregister.gov](https://www.federalregister.gov/documents/2026/11/09/2026-22750/calendar-year-2027-home-health-prospective-payment-system-hh-pps-rate-update-requirements-for-the-hh) - [2026-22750 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2026-11-09/pdf/2026-22750.pdf) ## Related - [Previous: 2026-22743, Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fe…](https://policyrisk.com/federal-register/2026-22743) - [Next: 2026-22761, Rules of Practice and Procedure for Administrative Hearings Before the Office o…](https://policyrisk.com/federal-register/2026-22761) - [All Federal Register documents](https://policyrisk.com/federal-register) Source: PRIA, https://policyrisk.com/federal-register/2026-22750 (as of 2026-11-11).