2026 Medicare Participation Announcement

Dear Providers,

On behalf of the Center for Medicare, I want to express our sincere gratitude for your unwavering commitment to delivering high-quality care to your patients—our Medicare beneficiaries.  Medicare is extraordinary.  Created through bipartisan support in 1965, it stands as one of the most important and enduring programs in our nation’s history—one that every working American contributes to and ultimately depends on, either now or in the future.  Your dedication is essential to ensuring Medicare continues to meet the needs of those it serves.  We at CMS are continually inspired by the many examples of your compassion, innovation, and excellence in care.  And we hope that you see us as we see you—partners in a shared mission—to ensure every Medicare beneficiary has access to the best possible care.  Each day, our work helps millions of Americans live longer, healthier lives, enabling them to reach their full potential—and in doing so, helping our nation reach its full potential as well.  Our shared mission to improve health outcomes through evidence-based care and accountability continues to drive our shared efforts.  The broader Medicare strategy for the coming year focuses on reducing administrative burden, removing regulation of where and how clinicians deliver care, improving program integrity, aligning payment with outcomes, and leveraging technology to promote whole-person care.  Key changes that we’re making for 2026 include:

• Reducing administrative burden
• Reducing regulatory burden on where and how clinicians deliver care
• Improving program integrity
• Aligning payment with outcomes
• Leveraging technology to promote whole-person care

See the full letter here: https://www.cms.gov/medicare-participation.

CY 2026 Home Health Prospective Payment System Final Rule

On November 28, CMS issued a final rule that announces policy changes under the Home Health (HH) Prospective Payment System (PPS), consistent with the legal requirements to update Medicare payment policies for home health agencies (HHAs) annually.  This rule finalizes routine, statutorily required updates to the HH payment rates for CY 2026.  The CY 2026 updated rates include the final CY 2026 HH payment update of an estimated 2.4% increase ($405 million increase), which is offset by an estimated 0.9% decrease that reflects the final permanent adjustment ($150 million decrease), an estimated 2.7% decrease that reflects the final temporary adjustment ($460 million decrease), and an estimated 0.1% decrease that reflects the updated fixed-dollar loss ratio for outlier payments ($15 million decrease).  CMS estimates that Medicare payments to HHAs in CY 2026 will decrease in the aggregate by an estimated 1.3%, or $220 million, compared to CY 2025, based on the finalized policies.

More Information:

• Full fact sheet
• Final rule
• DMEPOS Competitive Bidding Program fact sheet
• HH PPS webpage
• HHA Center webpage
• Home Health Patient-Driven Groupings Model webpage