As 2026 begins, home health agencies should keep an eye on several updates that could affect payments, documentation, and compliance. We have listed the updates we believe will matter most to agencies and have a direct impact on day-to-day operations. Staying informed will help agencies maintain quality care, optimize reimbursements, and remain compliant with CMS regulations.
Medicare Payment Update
According to the CY 2026 Final Rule, CMS projects a 1.3% decrease in aggregate Medicare payments to home health agencies in 2026—roughly $220 million compared to 2025. It’s important to note that this is an overall projection and does not translate uniformly across all agencies. The actual impact will vary depending on case mix, utilization, and compliance. With tighter margins, optimizing reimbursement through accurate, complete, and defensible documentation remains critical.
Telehealth Flexibility Extension
Current home health telehealth flexibilities are extended through January 30, 2026. While the expiration date is approaching quickly, lawmakers have previously indicated they are working toward a more permanent solution. Agencies should closely monitor developments, especially since many practitioners now rely on telehealth to complete the F2F encounter needed for home health admission.
Face-to-Face (F2F) Encounter Flexibility
The F2F encounter continues to allow flexibility: it may be completed by a qualified practitioner who is not the certifying practitioner, and that practitioner does not need to have treated the patient in a hospital or post-acute setting prior to home health admission. This remains an important operational allowance, especially for agencies working with diverse referral sources.
OASIS-E2 Implementation
OASIS-E2 is scheduled for implementation on April 1, 2026, with the draft OASIS-E2 Guidance Manual released on December 18, 2025. One notable proposed change is the retirement of Item O0350 (Patient’s COVID-19 vaccination is up to date). Agencies should begin reviewing the draft guidance now to identify workflow, training, and QA adjustments needed ahead of implementation.
Beyond these headline updates, agencies should also stay current on changes within the Home Health Quality Reporting Program (QRP) and Home Health Value-Based Purchasing (HHVBP). Familiarity with measure updates, scoring methodologies, and documentation expectations is key to maintaining compliance, protecting star ratings, and maximizing HHVBP incentives.
As 2026 unfolds, agencies that stay informed and proactive—especially around documentation, OASIS accuracy, and quality performance—will be in a stronger position to adapt to financial and regulatory shifts.
