To: HHA Providers, CMS Staff

Expanded HHVBP Model: Preview CY 2026 Annual Performance Reports (APRs) are Available in iQIES

*Not included in the TPS calculation for HHAs in the smaller-volume cohort. For additional details on cohort assignment in the expanded Model, please review Section 2 in the Expanded HHVBP Model Guide, available on the Expanded HHVBP Model webpage, under “FAQs & Model Guide."

Note: APRs are only available to HHAs through iQIES.

Below is a list of the calendar years that are relevant to the “CY 2026 APR”, namely the baseline year, performance year, publication year, and payment year.

• The baseline year is CY 2023 and is used to calculate quality measure-specific achievement thresholds and benchmarks for all measures except the DTC-PAC measure. For the DTC-PAC measure, CY 2022 and CY 2023 are used. CY 2023 (or CY 2022 and CY 2023 for DTC-PAC) and CY 2024 (or CY 2023 and CY 2024 for DTC-PAC) are used to calculate improvement thresholds depending on an HHA’s initial Medicare certification date and availability of sufficient data in the baseline years.
• CY 2025 is the performance year, and HHA performance in this calendar year is measured against 10 quality measures relative to performance of HHAs in each cohort.
• The publication year of the “CY 2026 APR” is CY 2026.
• CY 2027 is the payment year. That means that the HHA’s APP ranging from minus 5% to plus 5% is applied to Medicare Fee-for-Service (FFS) claims with through dates in CY 2027. Note that CMS applies the payment adjustment percentage to Home Health Prospective Payment System (HH PPS) Medicare claims, which are only available for Medicare (FFS) beneficiaries. Please note that this does not preclude other non-Medicare FFS payers (e.g., Medicare Advantage, Medicaid and managed Medicaid) from utilizing an agency’s HHVBP annual payment adjustment. For more information on the billing process, please review the “Billing Process” section in the Expanded HHVBP Model Guide.

The Appeals Process

There are three (3) versions of the APRs: a Preview APR, a Preliminary APR, and a Final APR.

• Once the “Preview APRs” are published, HHAs have 15 calendar days to submit a recalculation request if they find evidence of an error in their report.
  • The deadline for submitting a recalculation request for the CY 2026 APRs is September 4, 2026. Please note that recalculation requests do not apply to errors in data submission since submission requirements for the expanded Model align with current Code of Federal Regulations (CFRs).
• Once the “Preliminary APRs” are published on October 1, 2026, HHAs have 15 calendar days to submit a reconsideration request if they submitted a recalculation request and are not in agreement with the recalculation request decision.
  • The deadline for submitting a reconsideration request for the CY 2026 APRs is October 16, 2026.
  • HHAs also have 7 calendar days to submit a request for administrator review if they submitted a reconsideration request and are not in agreement with the reconsideration request decision.
  • The deadline for submitting a request for Administrator review for the CY 2026 APRs is November 5, 2026.
• CMS makes the “Final APRs” available after all recalculation requests, reconsideration requests, and requests for Administrator review are processed, and no later than 30 calendar days before the payment adjustment takes effect on January 1, 2027.

HHAs may submit requests for recalculation requests by emailing hhvbp_recalculation_requests@abtglobal.com. Recalculation requests must contain the following information, as cited in the CY 2022 HH PPS final rule (p. 62331) and CFR §484.375:

• The provider’s name, address associated with the services delivered, and CCN.
• The basis for requesting recalculation to include the specific data that the HHA believes is inaccurate or the calculation the HHA believes is incorrect.
• Contact information for a person at the HHA with whom CMS or its agent can communicate about this request, including name, email address, telephone number, and mailing address (must include physical address, not just a post office box).
• A copy of any supporting documentation, not containing PHI or PII, the HHA wishes to submit in electronic form.

Note: When submitting recalculation and reconsideration requests:

• CMS asks HHAs to only include one CCN per request.
• If you are submitting a recalculation request due to a suspected discrepancy between measure values reported in your APR and measure values calculated internally or by your HHA's vendor, please consider providing a copy of the internal/vendor report used to generate the internal data to assist CMS with investigating your HHA's request.
• If possible, confirm whether 1) your internal data are risk-adjusted and 2) the data source used to generate your internal measure values (e.g., OASIS data, claims data).
• Please do not include any PHI/PII or send any supporting information via links to file hosting services, including but not limited to Dropbox.

These instructions are also available on the Expanded HHVBP Model webpage, under “Model Reports.”

Contact Us

Please do not reply to this email – this is an unmonitored inbox. If you require assistance, use the following options:

• For program questions about the expanded HHVBP Model, contact the HHVBP Model Help Desk at HHVBPquestions@cms.hhs.gov.
• For support with registration for the Internet Quality Improvement and Evaluation System (iQIES), please contact our QIES/iQIES Service Center by phone at (800) 339-9313 or by email at iqies@cms.hhs.gov. You may also refer to the iQIES Onboarding Guide posted to QTSO for registration support: https://qtso.cms.gov/software/iqies/reference-manuals.
• To receive email updates about the expanded Model, please subscribe to the Expanded HHVBP Model listserv. Enter your email address in the contact form, then select “Home Health Value-Based Purchasing (HHVBP) Expanded Model” from the Innovations list.
• Please contact the Home Health Quality Reporting Program (HH QRP) Help Desk at homehealthqualityquestions@cms.hhs.gov for questions about the following: Home Health Quality, including Care Compare (excluding HHCAHPS), OASIS coding and OASIS documentation, quality reporting requirements & deadlines, data reported in quality reports, measure calculations, Quality of Patient Care Star Rating (excluding suppression requests), public reporting, risk adjustment, and Quality Assessment Only (QAO)/Pay for Reporting (P4P).
• Please contact the Home Health CAHPS Help Desk at hhcahps@rti.org for questions related to the HHCAHPS Survey or Patient Survey Star Ratings.

Important Links:

Expanded HHVBP Model webpage | Expanded HHVBP Model YouTube playlist