Precision Medical Billing

Heads Up, Agencies & Billers! 💸 NEW RULE ALERT = NEW RISK.

Recent payment rule changes have made documentation compliance more critical than ever. Our best advice? Run a comprehensive audit immediately.

CHECKLIST:
-Patient Eligibility
-OASIS/NOA Submissions
-Therapy Thresholds
-Outlier Claims

Don't let compliance errors turn into major revenue losses. Be proactive!

A huge thank you to our entire PMBi Family—students, clients, and partners alike! Your trust and unwavering dedication to excellence in billing and patient care inspires our team every day. We are proud to work alongside you! 🙌

🚨 CMS Proposed Rule Update: What Home Health Agencies Need to Know for 2026

CMS has released its proposed rule for CY 2026 — and the impact is significant.
Here’s the quick breakdown:

📉 Overall HH payments are projected to decrease by 6.4% — a $1.13B reduction.
📑 Permanent -4.059% PDGM adjustment to correct behavior-change assumptions.
🔁 Temporary -5% adjustment to begin recouping past overpayments.
🔧 Recalibrated case-mix weights, LUPA thresholds, comorbidity groups
👩‍⚕️ Expanded face-to-face encounter flexibility for physicians, NPs, PAs & CNSs
📊 QRP updates, HHVBP measure changes, DMEPOS accreditation reforms, and new proposals to strengthen program integrity.

Why it matters:
These changes could directly affect reimbursement, operational processes, and compliance risk for HHAs nationwide.

👉 How PMB Institute can help:
We break down complex CMS rule changes into practical, easy-to-understand training so your team stays compliant, confident, and ready for 2026.



Link to Full Article: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-home-health-prospective-payment-system-proposed-rule-fact-sheet-cms-1828-p?utm_source