October 1 update. Our PDGM and ICD-10 tools now use the FY2027 code set: 190 codes added, 30 deleted, and no existing code changed clinical group.

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Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update

Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies; Correction

Final

Proposed rule published July 3, 2024. Comments closed August 26, 2024. Final rule published November 7, 2024, effective January 1, 2025.

Docket
CMS-1803
RIN
0938-AV28
Documents
3 documents, July 3, 2024 to December 20, 2024
Amends
42 CFR parts 424, 483, 484

Documents

Oldest first

  1. July 3, 2024

    Comments closed

    Proposed rule, CMS-1803-P, 89 FR 55312, 114 pages

    Comments closed August 26, 2024. 968 comments posted on Regulations.gov as of October 9, 2026.

    CMS's summary

    “This proposed rule would set forth routine updates to the Medicare home health payment rates; the payment rate for the disposable negative pressure wound therapy (dNPWT) devices; and the intravenous immune globulin (IVIG) items and services payment rate for CY 2025 in accordance with existing statutory and regulatory requirements. In addition, it proposes changes to the Home Health Quality Reporting Program (HH QRP) requirements and provides an update on potential approaches for integrating health equity in the Expanded Health Value Based Purchasing (HHVBP) Model. It also proposes a new standard for acceptance to service policy in the HH conditions of participation (CoPs) and includes requests for information (RFIs) soliciting input on permitting rehabilitative therapists to conduct the initial and comprehensive assessment and the factors that may influence the patient referral and intake processes. Lastly, it proposes updates to provider and supplier enrollment requirements and changes to the long-term care reporting requirements for acute respiratory illnesses.”

    Dates

    “To be assured consideration, comments must be received at one of the addresses provided in the ADDRESSES section, no later than 5 p.m. EDT on August 26, 2024.”
  2. November 7, 2024

    Final rule

    Final rule, CMS-1803-F, 89 FR 88354, 132 pages

    Effective January 1, 2025.

    CMS's summary

    “This final rule will set forth routine updates to the Medicare home health payment rates; the payment rate for the disposable negative pressure wound therapy (dNPWT) devices; and the intravenous immune globulin (IVIG) items and services payment rate for CY 2025 in accordance with existing statutory and regulatory requirements. In addition, it finalizes changes to the Home Health Quality Reporting Program (HH QRP) requirements and provides an update on potential approaches for integrating health equity in the Expanded Health Value Based Purchasing (HHVBP) Model. It also finalizes a new standard for an acceptance-to-service policy in the HH conditions of participation (CoPs). Lastly, it updates provider and supplier enrollment requirements and changes to the long-term care reporting requirements for acute respiratory illnesses.”

    Dates

    “These regulations are effective on January 1, 2025.”
  3. December 20, 2024

    Correction

    Correction, CMS-1803-CN, 89 FR 104064, 3 pages

    Effective January 1, 2025.

    CMS's summary

    “This document corrects technical errors in the final rule that appeared in the November 7, 2024, Federal Register titled "Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies".”

    Dates

    “This correction is effective January 1, 2025.”

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What this tracks

Every CMS rule that amended 42 CFR Part 484 since 2002.

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Comment counts as posted on Regulations.gov.

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