Reimbursement

CY 2025 Home Health Prospective Payment System Final Rule Summary

17 hours ago

On November 7, 2024, CMS published in the Federal Register a final rule (89 FR 88354) addressing updates to the Home Health Prospective Payment System rates for home health agencies (HHAs), disposable negative pressure wound therapy devices, and intravenous immune globulin items and services for calendar year 2025. In addition, CMS also finalizes a permanent prospective behavior adjustment to the 2025 home health payment rate to account for the impact of the implementation of the PDGM. Specifically, CMS finalizes a -1.975 percent (half of the proposed) permanent adjustment to the 2024 30-day payment rate as it believed that the full permanent reduction in a single year may be too burdensome for certain HHA providers. This adjustment accounts for any changes in aggregate expenditures resulting from the difference between assumed behavior changes and actual behavior changes, due to implementation of the PDGM and 30-day unit of payment.

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