in effect
This is a final rule issued by the Centers for Medicare & Medicaid Services (CMS), effective January 1, 2026, that sets the annual Medicare payment rates for home health agencies and updates rules governing medical equipment suppliers. It also modifies quality reporting requirements, provider enrollment standards, and the competitive bidding program used to set prices for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).
Medicare home health payment rates increase by 2.4 percent for 2026, but that increase is offset by a permanent downward adjustment of 1.023 percent and a temporary downward adjustment of 3.0 percent to the base rate, resulting in a net decrease in payments. Accreditation of DMEPOS suppliers must now happen every year instead of the previous three-year cycle. Providers and suppliers must report adverse legal actions against them within 30 days instead of the previous 90-day window. Continuous glucose monitors and insulin infusion pumps will now be paid on a bundled monthly rental basis rather than through the prior purchase model, allowing beneficiaries to upgrade to newer devices without waiting five years. The formula for calculating competitive bid payment amounts (single payment amounts) shifts from using the maximum winning bid to the 75th percentile of winning bids, and an annual inflation adjustment is added to those amounts for multi-year contracts.
Home health agencies will see adjusted reimbursement rates and face updated quality reporting and patient assessment requirements, including removal of the COVID-19 vaccination tracking measure. DMEPOS suppliers face more frequent accreditation surveys, revised competitive bidding rules, and new enrollment reporting obligations. Medicare beneficiaries who receive home health services or rely on durable medical equipment such as glucose monitors and insulin pumps will be subject to the new payment structures that govern what their suppliers are paid.