Skip to main content

In this review: Medicare and Medicaid Programs: Calendar Year 2026 Home Health Prospective Payment System Rate Update, etc.

Effective date: Jan. 1, 2026

CMS fact sheet

The Big Picture

In its final 2026 payment rule, the Centers for Medicare & Medicaid Services delivers a cut to home health agency reimbursement due to implementation of the Patient-Driven Groupings Model. The result is a 1.3% (or $220 million) decrease from 2025 levels, a significant difference from the proposed 6.4% reduction. This will be the first year that home health agencies see cuts as a result of the temporary behavioral adjustment.

In its comments on the proposed rule, APTA argued against significant cuts that could negatively impact patient access to PT services. APTA also created a template letter for members to share their feedback with CMS.

Log in or create a free account to keep reading.


Join APTA to get unlimited access to content.


You Might Also Like...

News

Essential Education on Medicare Part B: New Course Free for Members

Jan 20, 2026

The new APTA Learning Center course offers a comprehensive breakdown of how payment works and how to avoid common compliance pitfalls.

News

CMS Launches Models for Chronic Care Management and Lifestyle Interventions

Jan 5, 2026

APTA attends ACCESS model launch and highlights opportunities for PTs in both ACCESS and MAHA ELEVATE models.

Article

CMS Updates Guidance to Reflect Current Plan of Care Signature Exception

Dec 3, 2025

A recent U.S. Centers for Medicare & Medicaid Services’ MLN Matters update provided guidance on a range of topics, including the plan of care signature