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

What it does

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.

The Centers for Medicare & Medicaid Services's summary, as published in the Federal Register.

What changed in the regulation

8 parts of Title 42 of the Code of Federal Regulations:

42 CFR 405, 42 CFR 410, 42 CFR 414, 42 CFR 422, 42 CFR 423, 42 CFR 424, 42 CFR 484, 42 CFR 498

Wording on eCFR: the day before it took effect and from the day it took effect (first part listed).

Compared with

The Centers for Medicare & Medicaid Services has published 24 final rules in 2026 so far, compared with 12 in all of 2025.

Counted by the Tribune from Federal Register records since Jan. 1, 2025.

Before this

1 earlier Federal Register document under regulation identifier 0938-AV80 since Jan. 1, 2025.

• July 6, 2026 Proposed rule. 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

What happens next and when

With the exception of the HH PPS and HH QRP provisions specified in sections II. and III. of this final rule and the regulatory changes at 42 CFR 484.245, these regulations are effective on January 4, 2026. The HH PPS and HH QRP provisions specified in sections II. and III. of this final rule and the regulatory changes at 42 CFR 484.245 are effective January 1, 2027.

The agency's dates, word for word.

Check it yourself

• The document in the Federal Register
• Title 42 on eCFR

The record as published

Source: the Federal Register (public domain). The document in the Federal Register