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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

Position Paper: EMPOWER Act

Aug 2, 2023 / Position Paper

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

APTA Receives CMS Clarification on 'Attending Clinician' Medicare Billing Issue

Jul 11, 2023 / News

Some institutional settings have been receiving denials with little explanation. Here's what happened, and what you need to do.

Win: Medicare Contractors Will Continue to Pay for Remote Therapeutic Monitoring

May 24, 2023 / News

The decision to back off from locally based coverage decisions was fueled by APTA advocacy efforts.

APTA Regulatory, Legislative, and Payment Updates Webinar Series

Apr 5, 2023 / Resource

Get inside intel from APTA's Health Policy & Payment staff in these live webinars about the latest and most pressing payment and regulatory issues, and pose your questions to staff experts.

MPPR Calculator Instructions

Jan 12, 2023 / Resource

CMS Makes Changes to DMEPOS Prior Approval, Other Restriction Lists

Jan 21, 2022 / News

The changes, many of which could affect PTs, will begin April 13. Now's the time to prepare.

Final DMEPOS Rule Streamlines Benefit and Payment Processes for Certain Devices

Jan 11, 2022 / Review

CMS also chooses to not finalize reforms to the HCPCS Level II application process.

Advocacy Update

Nov 23, 2021 /

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.

Advocacy Update: Fight the Cut

Sep 3, 2021 /

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 25, 2021 /

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