This is the first issue of The Rulebook, the monthly home health regs digest. Three blocks, one screen: what changed, one OASIS item explained, one tool. Every number below is quoted from the CMS source it links to, and every block links to a page that stays up after the email is gone.
What changed on October 1
Three CMS dates landed on the same day.
The PDGM grouper moved to v07.2.26 and picked up the FY2027 ICD-10-CM codes. It adds 190 codes and deletes 30. No code that was already in the table changed its clinical group, comorbidity subgroup or principal-diagnosis flag. The risk is not a quiet regrouping. It is billing a deleted code, or reaching for a new unspecified code that CMS assigns to no group at all. The grouper picks its table by the claim's from date, so a 30-day period that started September 30 still groups under the old table. The FY2027 changes and the successor codes.
Your preliminary HHVBP Annual Performance Report posted. It holds one number: the percentage CMS adds to, or takes off, every Medicare fee-for-service home health claim you bill in 2027, up to 5 percent either way, based on care delivered in 2025. For nearly every agency the window to dispute it has already closed, because recalculation requests were due 15 days after the August preview. Read it, check it, budget around it. How the number is built and who can still appeal.
Care Compare star ratings refresh this month, on 2025 claims for the first time. January, April and July all used 2024 claims. The one claims-based measure, potentially preventable hospitalizations, moves by a full year of data in one step, and your star can move with it. The new national cut points for all seven measures.
One code explained: GG0170R, wheel 50 feet with two turns
Of all the Section GG questions that bring people to this site, the wheelchair one is cited most. Not a walking item. The OASIS-E2 Guidance Manual defines GG0170R as "once seated in a wheelchair/scooter, the ability to wheel at least 50 feet and make two turns."
Three things the manual says that charts get wrong:
- The turns are 90-degree turns, anywhere in the 50 feet, in the same direction or different directions.
- The transfer does not count. "Assistance provided with the transfer is not considered when scoring Wheel 50 feet with two turns."
- A pushed patient is still scored. The wheelchair items cover "those who require a helper to push them in a wheelchair," so a patient who wheels 10 feet and is pushed the other 40 is coded 02, substantial/maximal assistance, because the helper did more than half the effort.
And the gateway item above it, GG0170Q, is only coded 0 if the patient does not use a wheelchair or scooter "under any condition." A patient who borrows the facility's chair for activities is a yes. GG0170R in the item lookup, with the full six-point scale.
One tool: build a HIPPS code
The HIPPS decoder has run the other way since this week. Pick the four decisions behind a 30-day period, admission source and timing, clinical group, functional level and comorbidity adjustment, and read the five-character code off, with the CMS citation under each character. Same table as the decoder, so the two cannot disagree. Grouping only, no dollar figures. Build a code.
Next issue
Early November, or the day the CY2027 home health final rule drops, whichever comes first. The rule is expected late October or early November. When it lands, the rates, LUPA thresholds and functional points pages on this site are updated within days, and the special issue goes out the same day.
Sources
- CMS, Home Health PDGM Grouper Software v07.2.26 (tables effective October 1, 2026); CDC NCHS ICD-10-CM Conversion Table FY2027.
- CMS, Expanded HHVBP Model Guide (December 2025) and June 2026 newsletter; 42 CFR 484.345 through 484.375.
- CMS, Home Health Quality of Patient Care Star Rating Provider Preview Reports, October 2026.
- CMS, OASIS-E2 Guidance Manual, effective April 1, 2026, Section GG, GG0170Q and GG0170R coding tips and examples.
- CY2026 HH PPS Final Rule (CMS-1828-F), Table 13, HIPPS code structure.