CMS Finalizes Home Health Payment Updates and Quality Reporting Changes for 2025

The Centers for Medicare & Medicaid Services (CMS) has finalized the payment rates and policies for Home Health Agencies (HHA) for the calendar year 2025.

Payment Rates and Policies

The finalized adjustments include a permanent reduction of 1.975% to account for the transition to the patient-driven groupings model (PDGM).

The payment rates will increase by 2.7%, resulting in a modest estimated net increase of 0.5% compared to the previous year.

New Reporting Standard

CMS has also introduced a new reporting standard to replace the existing COVID-19 reporting requirements, which will encompass a broader range of acute respiratory illnesses.

Enrollment Process Update

The enrollment process for providers reactivating Medicare billing privileges has been updated to mitigate issues related to fraud, waste, and abuse.

Quality Reporting Program and Value-Based Purchasing Model

The Home Health Quality Reporting Program (HHQRP) and the Home Health Value-Based Purchasing (HHVBP) model have been updated with new quality measures that focus on social determinants of health.

Area Wage Indexes

CMS has adopted the Office of Management & Budget's (OMB) July core-based statistical area (CBSA) delineations for 2025, resulting in changes to area wage indexes.

Health Equity

CMS is placing a strong emphasis on health equity within the expanded HHVBP model and is exploring the incorporation of a Health Equity Adjustment.

New Reporting Requirements

New reporting requirements for respiratory illnesses in long-term care facilities have been finalized, which will replace the existing reporting framework.

These changes reflect a significant shift in the home health care landscape, with a focus on quality, equity, and responsiveness to emerging health challenges.

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