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...

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

News

Aetna Updates Policy to Better Align With PT Practice and CPT Code Definitions

Nov 4, 2025

The win is a continuation of APTA’s efforts to promote the adoption of payer policies that are favorable to the profession and patients.   

Article

Physical Therapy in the News: October 2025

Nov 4, 2025

"Physical Therapy in the News" is a monthly series that highlights recent media coverage of the profession and APTA members, with an emphasis on stories