Your CY2027 HHVBP payment adjustment is in iQIES. The reconsideration window closes October 16.

CMS published Preliminary CY 2026 Annual Performance Reports (Preliminary APRs) for the expanded Home Health Value-Based Purchasing Model in iQIES on October 1, 2026. Every enrolled home health agency now has a real number in the system: the Annual Payment Percentage (APP) that will be applied to every Medicare fee-for-service 30-day period episode with a through date in CY 2027. This is not a projection. It is the number — pending reconsideration and the Final APR — that your billing team will see on every Medicare FFS claim starting January 1.

The reconsideration window is open now and closes in four days: October 16, 2026.

What the Preliminary APR contains

The Preliminary APR incorporates any approved adjustments from recalculation requests submitted before the September 4 deadline. If your agency submitted a recalculation request and it was approved, the adjustment appears in the Preliminary APR. If the request was denied, the denial rationale is included. If your agency did not submit a recalculation request before September 4, the Preliminary APR reflects the same calculation as your Preview APR from August.

The APP range under the expanded HHVBP model is −5% to +5%, applied to the base Medicare FFS rate on each 30-day period claim. For an agency billing $2 million in annual Medicare FFS home health, the difference between a −5% and a +5% adjustment is $200,000 per year — not a reconciliation payment, but a per-claim multiplier applied continuously throughout 2027.

What the reconsideration window covers — and what it doesn't

A reconsideration request addresses one narrow category: a calculation error in how CMS applied your submitted data to produce the APP. It is not a mechanism to dispute clinical outcomes, contest OASIS documentation quality, or challenge a measure definition. Agencies that missed the September 4 recalculation deadline cannot request a new recalculation at this stage.

If your agency submitted a recalculation request and the result in your Preliminary APR is still incorrect — a wrong denominator, a miscounted episode, a misapplied exclusion that persists after the recalculation — the reconsideration window is the mechanism to contest that specific decision. If a new discrepancy appears in the Preliminary APR that was not present in the Preview APR, that is also eligible for reconsideration.

After October 16, agencies that disagree with a reconsideration decision have until November 5 to request an Administrator review. That is the final formal step before the Final APR publishes later in November.

What your agency should do before October 16

1. Log into iQIES, pull your Preliminary APR, and read the APP column. This is your CY2027 payment adjustment as it currently stands. Your billing director and clinical leadership should both see it today.
2. Compare the Preliminary APR calculation to your Preview APR. If you submitted a recalculation request in August and the adjustment was approved, verify the change is reflected. If the request was denied, read the denial rationale before the October 16 reconsideration window closes.
3. Cross-reference the denominator figures against your internal CY2025 episode records. Total qualifying Medicare FFS admissions, matched-pair OASIS completion counts, and HHCAHPS survey sample volume. A discrepancy that wasn't apparent in August sometimes surfaces when the recalculation result is applied. If the Preliminary APR denominator is materially below your internal records, investigate before the window closes.
4. If you find a calculation error, file the reconsideration request by October 16. Document the specific discrepancy, include supporting data, and submit through iQIES. Late requests are not accepted.

The November timeline

Final APRs publish in November, typically in the same window as the CY2027 Home Health PPS Final Rule (CMS-1844-P). The APP in the Final APR is the number applied to CY2027 claims — no further adjustment requests are accepted after that publication. The proposed CY2027 rule (published July 6) proposed a 2.4% net aggregate increase, a continuing −3.0% temporary PDGM recoupment adjustment, and LUPA threshold changes across all HHRGs. The final rule will be effective January 1, 2027. Agencies reviewing the Final APR and the Final Rule on the same November timeline have two interconnected planning inputs arriving simultaneously — the APP that goes on every claim, and the base rate and LUPA thresholds those claims are calculated against.

What we built for this

Carelytic's Quality Metrics dashboard surfaces OASIS matched-pair completion rates by clinician and caseload throughout the year — the same denominator data CMS uses in HHVBP outcome measure calculations. When an OASIS discharge assessment is missing, it shows up in the dashboard during the care period, not in an August APR when the performance year has already closed. The LUPA Risk Dashboard will update PDGM thresholds for CY2027 when the final rule publishes in November, so your scheduling and visit-utilization decisions for January start from the correct thresholds rather than the CY2026 numbers.