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Volume 21.07

CMS has finalized 2022 home health reimbursement rates.  Standard rates have increased by a net 2.6%, which is the result of an inflation update of 3.1% reduced by a .5% productivity adjustment.

The base 30-day rate increased to $2,031.64 from $1,901.12.  The LUPA per-visit rates increased to:

  • Home Health Aide                                $   71.04
  • Medical Social Services                        $ 251.48
  • Occupational Therapy                           $ 172.67
  • Physical Therapy                                  $ 171.49
  • Skilled Nursing                                     $ 156.90
  • Speech-Language Pathology                $ 186.49

A notable change in the final rule is the removal of the five percent (5%) limitation on any reduction in the wage index from the prior year.  Home health agencies could see a significant impact if their patients are physically located in specific geographical areas with a significant decline in the wage index.

This final rule makes permanent the changes to the home health Conditions of Participation (“CoP”) that were implemented during the COVID-19 public health emergency (PHE) and finalizes other changes to the CoPs.  This includes making permanent the current blanket waivers related to home health supervision and the use of telecommunications in conducting assessment visits.

This rule also finalizes changes applicable to other providers:

  • Finalizes changes to the Home Health, Long -Term Care Hospital (“LTCH”), and Inpatient Rehabilitation Facility (“IRF”) Quality Reporting Programs (“QRP”).
  • Finalizes revisions to the infection control requirements for Long-Term Care Facilities (Medicaid nursing facilities and Medicare skilled nursing facilities, also collectively known as “nursing homes”) that will extend the mandatory COVID-19 reporting requirements beyond the current COVID-19 PHE until December 31, 2024.
  • Incorporates into regulation several existing Medicare provider enrollment policies; and
  • Finalizes survey and enforcement requirements for hospice programs to implement provisions of the Consolidated Appropriations Act, 2021.

The rule begins the process of nationalizing the Home Health Value-Based Purchasing (“HHVBP”) Model and updates home infusion therapy services payment rates.

The final rule can is available here.


Home health agencies had significant difficulty in addressing cost report changes that were effective with the filing of the cost reports for 2020.  While agencies continue to deal with the continuing COVID-19 PHE, it is time to make certain systems produce the information needed for the 2021 cost reports.  There is no current information available to indicate an extension to the cost report filing dates such as the extensions provided for the 2019 and 2020 filings.  Agencies should plan for filing on scheduled due states; currently May 31, 2022 for December 31, 2021 filings.