Specialty intelligence

Home Health Reimbursement Alerts

Daily CMS policy updates, MAC LCD revisions, and coding guidance for Home Health billing teams. All alerts sourced directly from CMS, MAC contractor sites, and the Federal Register.

Critical alerts active

Total alerts

Average signal

71/100

Sources monitored

15+

Latest Home Health alerts

Federal Register Final Rule: Medicare Program; Calendar Year (CY) 2024 Home Health (HH) Prospective Payment System Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin Items and Services; Hospice Informal Dispute Resolution and Special Focus Program Requirements, Certain Requirements for Durable Medical Equipment Prosthetics and Orthotics Supplies; and Provider and Supplier Enrollment Requirements

Home Health · Effective 2024-01-01

Federal Register Final Rule: Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies

Home Health · Effective 2025-01-01

Federal Register Final Rule: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements

Home Health · Effective 2025-10-01

Federal Register Final Rule: Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies

Home Health

Federal Register Proposed Rule: Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies

Home Health

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MAC contractor coverage

Home Health billing is subject to both national CMS policy and regional MAC contractor Local Coverage Determinations (LCDs). CLV Intelligence monitors all MAC contractor sites — Noridian, CGS, First Coast, NGS, Novitas, Palmetto GBA, and WPS — for LCD updates affecting Home Health codes. Coverage criteria vary by contractor jurisdiction.

NoridianCGS AdministratorsFirst CoastNational Government ServicesNovitas SolutionsPalmetto GBAWPS

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Weekly digest of CMS and MAC policy changes for Home Health billing teams.

Frequently asked questions

What MAC contractors issue LCDs for Home Health billing?

Home Health billing is subject to regional Local Coverage Determinations (LCDs) from all seven Medicare Administrative Contractors: Noridian, CGS Administrators, First Coast Service Options, National Government Services, Novitas Solutions, Palmetto GBA, and WPS Government Health Administrators. Coverage criteria and medical necessity requirements vary by contractor jurisdiction. CLV Intelligence monitors all MAC contractor sites daily for LCD updates affecting Home Health codes.

How often does CMS update Home Health reimbursement policy?

CMS updates the Physician Fee Schedule annually, effective January 1, with proposed rules published in the summer and final rules in November. MAC contractors issue LCD updates on a rolling basis throughout the year with no fixed schedule. The Federal Register publishes proposed and final rules affecting Home Health reimbursement on a continuous basis. CLV Intelligence monitors all three sources daily and surfaces updates by signal strength.

What is a Local Coverage Determination (LCD) and how does it affect Home Health billing?

A Local Coverage Determination (LCD) is a decision by a Medicare Administrative Contractor specifying under what clinical circumstances a particular service is covered within its geographic jurisdiction. For Home Health billing teams, LCDs define medical necessity criteria, covered diagnoses, and documentation requirements for specific procedures. Failure to comply with LCD requirements is among the most common causes of Medicare claim denial in Home Health practices.

Reimbursement guides & resources

Plain-language guides to the policy cycles that drive Home Health reimbursement — the fee schedule, ICD-10, HCPCS, and Local Coverage Determinations.

2027 Fee Schedule Guide

How the CY2027 Medicare Physician Fee Schedule works and what to track.

ICD-10 Change Center

The FY2027 ICD-10-CM update cycle and the October 1 effective date.

HCPCS Quarterly Update

How HCPCS Level II changes every quarter — Jan, Apr, Jul, Oct.

Tracking LCD Changes

How LCDs change across all seven MACs and how to track them.

2027 Prep Checklist

A free, printable checklist for the CY2027 fee schedule cycle.

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