PDGM Rates
The CY 2026 national, standardized 30-day period base rate and national per-visit amounts, how the period payment is assembled, and the adjustment factors behind the number.
Data statusReference Only
- Status
- Reference Only
- Data year / effective
- CY2026
- Last reviewed
- June 2026
- Last updated
- June 2026
- Primary source
- CMS Home Health PPS Final Rule, CY2026
- Known exclusions
- Wage-index / CBSA adjustment varies
- LUPA, PEP, and outlier policy may apply
- Sequestration and MAC edits not applied
Published reference for the stated period — confirm the current figure and any corrections at the source before billing.
CY 2026 30-day period base rate
Eff. Jan 1 2026Source: CY 2026 HH PPS Final Rule (CMS-1828-F); CMS MLN Matters MM14304, eff. Jan 1 2026.
Adjustment factors
CY 2026 national per-visit amounts
LUPA & outliersPer-visit amounts pay LUPA periods (when visits fall below the threshold) and feed outlier cost imputation. The LUPA add-on applies to the first skilled visit when the period is the only or initial 30-day period in a sequence.
| Discipline | CY 2025 | CY 2026 | CY 2026 + LUPA add-on |
|---|---|---|---|
| Skilled Nursing SN | $172.73 | $176.96 | $304.37 ×1.7200 |
| Physical Therapy PT | $188.79 | $193.42 | $313.82 ×1.6225 |
| Occupational Therapy OT | $190.08 | $194.74 | $335.69 ×1.7238 |
| Speech-Language Pathology SLP | $205.22 | $210.25 | $351.03 ×1.6696 |
| Medical Social Services MSS | $276.85 | $283.64 | — |
| Home Health Aide HHA | $78.20 | $80.12 | — |
Open the LUPA Calculator → Open the PDGM Calculator →
Source: CY 2026 HH PPS Final Rule, national per-visit table; LUPA add-on factors SN 1.7200 · PT 1.6225 · OT 1.7238 · SLP 1.6696. Verify against the CMS HH PDGM source before billing.
