CMS Approves 0.5% Payment Increase in 2025 for Home Health

The Centers for Medicare & Medicaid Services (CMS) has finalized a home health prospective payment rule for 2025 that includes a 0.5% aggregate increase in Medicare home health reimbursement, translating to approximately $85 million. This adjustment marks a shift from the proposed 1.7% decrease, reflecting ongoing adjustments related to the Patient-Driven Groupings Model (PDGM). Despite this improvement, stakeholders in the home health sector expressed dissatisfaction, emphasizing that the overall trend has been toward significant cuts and insufficient recognition of inflationary pressures on costs.

In addition to the payment adjustments, the rule introduces new standardized patient assessment items, including aspects related to living situations and nutrition, while imposing new Conditions of Participation requiring agencies to maintain acceptance-to-service policies. Stakeholders have criticized these new requirements as adding administrative burdens without addressing the root causes of care access issues. Overall, home health advocates are urging Congress to intervene and rectify what they perceive as a flawed payment system that has led to ongoing financial challenges for providers.

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