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We help you keep track of evolving payment policies for home health.

Medicare payment for home health physical therapy services is under a prospective payment system, meaning there’s a predetermined base payment according to a classification system of services — in the case of home health, the Patient-Driven Groupings Model.

Home health services also are subject to quality reporting requirements using OASIS — the Outcome and Assessment Information Set.

See more information on home health physical therapy.


Recommended Content

APTA Suggests: More on the Review Choice Demonstration

May 24, 2020 / Article

Patient-Driven Groupings Model

Jun 6, 2020

The PDGM is a shift away from volume-driven home health payment to a model that focuses on the unique characteristics, needs, and goals of each patient.

CMS Resources on Payment in the Home Health Setting

May 24, 2020 / Article

APTA Home Health Section

Jan 1, 2020 / Website


Additional Medicare Payment for Home Health Content

Advocacy Update

Nov 23, 2021 / Podcast

As Congress attends to business in the last days before recess for the year, there are several important issues on the table, including a bill to address the fee schedule cuts, and legislation aimed at the PTA differential.

Position Paper: PTA Differential

Aug 13, 2021 / Position Paper

Beginning in January 2022, payment for Medicare Part B services provided by PTAs will be reduced by 15% due to a provision in the Balanced Budget Act of 2018.

Advocacy Update: Fight the Cut

Sep 3, 2021 / Podcast

This podcast provides an advocacy update focusing on the 2022 Medicare Physician Fee Schedule proposed rules. Where we are—and what needs to happen next.

FightTheCut Rally Fee Schedule, and August Recess - Advocacy Update

Aug 26, 2021 / Podcast

Get updates on the proposed Medicare physician fee schedule, what we’re doing to #FightTheCut, and how you can help.

Position Paper: Medicare Fee Schedule

Aug 18, 2021 / Position Paper

The proposed 2022 Medicare Physician Fee Schedule rule includes deep cuts to critical services provided by dozens of health care providers, including PTs and PTAs.

Proposed FY '22 IRF Rule: 2.2% Increase; Call for Input on Equity, Reporting

Apr 13, 2021 / Review

As the U.S. health care system continues to struggle with a pandemic and its fallout, CMS keeps IRF payment changes relatively minimal.

Quick Guide To Using the PTA Modifier

Aug 20, 2020 / Resource

Use this guide to help you identify when you must apply the CQ modifier, which we updated in March 2021 to reflect new details from CMS.

CMS To Begin Recovering Money From Providers Who Received COVID-19 Loans

Mar 17, 2021 / News

Time is up on the moratorium on recoupment for funds received through the Accelerated & Advance Payment program.

MPPR Calculator Instructions

Feb 5, 2021 / Resource

Code Pairing Edits: Four Things To Know

Jan 25, 2021 / Article

APTA successfully advocated for CMS to lift misguided coding edits, and we're working to bring commercial payers around.