Enzo Academy
Home Health
For owners and administrators: the payment, quality and review rules that decide what your agency is paid, in plain English.
Your California agency has until December 16, 2026 to choose how Medicare reviews every claim. Miss it and you're in postpayment review, answering a records request on each one. In the six states already in the program, most agencies were in pre-claim review.
Your 2025 quality scores have already set a percent, up to 5% up or down, that Medicare applies to your traditional Medicare home health claims in 2027; on $5 million of that revenue, each 1% is $50,000 a year.
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