CMS releases CY 2025 home health PPS final rule, partially delays behavioral adjustments

American Hospital Association November 1, 2024

The Centers for Medicare & Medicaid Services today issued its calendar year 2025 final rule for the home health prospective payment system. Overall, this rule will increase HH payments by $85 million, or 0.5% compared to CY 2024. This update is the result of a 3.2% market basket update, offset by a 0.5% productivity reduction. In addition, CMS says payments will be reduced by 0.4% overall due to changes to fixed-dollar loss ratio for outlier payments. Further, CMS is applying a behavioral adjustment of -1.8% as required as part of implementation of the new Patient Driven Groupings Model. This reduction is half of the -3.6% CMS originally proposed due...

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