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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

APTA Payment and Regulatory Update Webinar Series

May 18, 2022 / Resource

These live webinars give APTA members the opportunity to learn about the latest and most pressing payment and regulatory issues, as well as pose questions to staff experts.

Position Paper: PTA Differential

Mar 2, 2022 / 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.

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.

Position Paper: Medicare Fee Schedule

Dec 2, 2021 / Position Paper

The 2023 Medicare Physician Fee Schedule proposed rule released by CMS includes deep cuts to needed services provided by dozens of health care providers, including physical therapists.

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.

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

Mar 19, 2021 / 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.