CMS has issued its 2025 final rule for the home health payment system, increasing payments by 0.5% ($85 million) over 2024.
Three things to know:
1. This includes a 3.2% market update, offset by a 0.5% productivity cut and a 0.4% reduction for outlier payments.
2. A -1.8% behavioral adjustment — half of the originally proposed -3.6% — will also take effect Jan. 1 as part of the implementation of CMS' new patient driven groupings model. CMS plans to apply the remaining adjustment in future years.
3. For quality reporting, CMS will add four new social determinants of health measures in 2027. Additionally, it set new standards for HH agency service policies and requires respiratory illness reporting in long-term care facilities beginning Jan. 1.