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In the fall of every year the home health industry waits in anticipation as CMS prepares to publish the Final Rules for the next year. Thankfully, in the summer, CMS does provide a prequel and an opportunity for the industry to submit comments related to the proposed changes. We are currently in that comment period. CMS published the 2026 Proposed Rules in the Federal Register recently and along with PDGM and payment rate changes, a significant proposed change revolves around the face-to-face encounter policy.

Since its inception, the face-to-face encounter policy has been an area of constant change and controversy. There have been differences in interpretation of the policy, even by the Medicare Administrative Contractor’s (MAC’s). It was noted in the 2026 proposed rule that previous commenters have pointed out that Section 3708 of the CARES Act allowed for nurse practitioners (NPs), clinical nurse specialists (CNSs), and physician assistants (PAs) to order and certify patients for eligibility under the Medicare home health benefit and establish a plan of care. CMS has agreed with the commenters and is proposing to change the face-to-face regulation to allow physicians, in addition to NPs, CNSs, and PAs, to perform the face-to-face encounter regardless of whether they are the certifying practitioner or whether they cared for the patient in the acute or post-acute facility from which the patient was directly admitted to home health and who is different from the certifying practitioner. 

This proposed change would broaden the number of practitioners who can perform the face-to-face encounter and alleviate much of the uncertainty that revolves around the face-to-face encounter requirement.  

For more information, please visit:  https://www.govinfo.gov/content/pkg/FR-2025-07-02/pdf/2025-12347.pdf