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Medicare Post-Acute Care Utilization - Home Health Agency by Geography, Provider and Service

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Last posted: Aug 11, 2026
Period covered: Jan 1, 2024 to Dec 31, 2024
Update frequency: Annually

Dates as CMS lists them in its catalog.

Columns 33

Column	What it means	Type
Year`YEAR`	The year of data.	string
Year Type`YEAR_TYPE`	Identifies if the data is for calendar year (CY) or fiscal year (FY).	string
Summary Category`SMRY_CTGRY`	Identifies if the data is at the national, state, or provider level.	string
Service Category`SRVC_CTGRY`	Identifies the PAC setting: HH, hospice, SNF, IRF, or LTCH.	string
State`STATE`	The state where the provider is located, as reported in Provider of Services file. The fifty U.S. states, the District of Columbia, and Puerto Rico are reported by their postal abbreviation. Note for national level, no state is reported.	string
Provider ID`PRVDR_ID`	The 6-digit CCN for the provider.	string
Facility Name`PRVDR_NAME`	The provider name, as reported in the Provider of Services file.	string
City`PRVDR_CITY`	The city where the provider is located, as reported in the Provider of Services file.	string
ZIP`PRVDR_ZIP`	The provider’s ZIP code, as reported in the Provider of Services file. Note, for state and national levels, ZIP code is not reported.	string
Grouping`GRPNG`	The 5-character HIPPS.	string
Grouping Description`GRPNG_DESC`	Tithe description of the first 4-characters of the HIPPS code (note: even though the GRPNG variable includes 5 characters).	string
Distinct Beneficiaries`BENE_DSTNCT_CNT`	Number of unique Medicare beneficiaries with at least one paid claim in the calendar or fiscal year.	number
Total Count of Episodes or Periods`TOT_EPSD_STAY_CNT`	This is the count of 30-day episodes.	number
Days of Service`TOT_SRVC_DAYS`	Total count of covered days delivered by a provider in the CY.	number
Average Charge Per Beneficiary`AVG_CHRG_PER_BENE`	Average of the Total Charge Amount per beneficiary. The Total Charge Amount is the total charges submitted by the provider.	number
Average Allowed Amount Per Beneficiary`AVG_ALOWD_AMT_PER_BENE`	Average of the Medicare Allowed Amount per beneficiary. Typically, the Medicare Allowed Amount is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying; however, for Home Health, there is no cost sharing and the allowed amount is the same as Medicare payment amount.	number
Average Payment Amount Per Beneficiary`AVG_PYMT_AMT_PER_BENE`	Average of the Total Medicare Payment Amount per beneficiary. The Total Medicare Payment Amount is the total amount that Medicare paid after deductible and coinsurance amounts have been deducted.	number
Average Standardized Payment Amount Per Beneficiary`AVG_STDZD_PYMT_AMT_PER_BENE`	Average of the Total Medicare Standardized Payment Amount per beneficiary. The Medicare Standardized Payment Amount is the total amount that Medicare paid adjusted for geographic differences in payment rates.	number
Average Charge Per Episode`AVG_CHRG_PER_EPSD`	Average of the Total Charge Amount per Episode. The Total Charge Amount is the total charges submitted by the provider. This only applies to the HH Provider by HHRG supplemental file.	number
Average Allowed Amount Per Episode`AVG_ALOWD_AMT_PER_EPSD`	There is no cost sharing for Home Health; therefore, allowed amount is the same as Medicare payment amount.	number
Average Payment Amount Per Episode`AVG_PYMT_AMT_PER_EPSD`	Average of the Total Medicare Payment Amount per Episode. The Total Medicare Payment Amount is the total amount that Medicare paid after deductible and coinsurance amounts have been deducted. This only applies to the HH Provider by HHRG supplemental file.	number
Average Standardized Payment Amount Per Episode`AVG_STDZD_PYMT_AMT_PER_EPSD`	Average of the Total Medicare Standardized Payment Amount per Episode. The Medicare Standardized Payment Amount is the total amount that Medicare paid adjusted for geographic differences in payment rates. This only applies to the HH Provider by HHRG supplemental file.	number
Average Charge Per Day`AVG_CHRG_PER_DAY`	Average of the Total Charge Amount per Day. The Total Charge Amount is the total charges submitted by the provider.	number
Average Allowed Amount Per Day`AVG_ALOWD_AMT_PER_DAY`	Average of the Medicare Allowed Amount per Day. Typically, the Medicare Allowed Amount is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying; however, for Home Health, there is no cost sharing and the allowed amount is the same as Medicare payment amount.	number
Average Payment Amount Per Day`AVG_PYMT_AMT_PER_DAY`	Average of the Total Medicare Payment Amount per Day. The Total Medicare Payment Amount is the total amount that Medicare paid after deductible and coinsurance amounts have been deducted.	number
Average Standardized Payment Amount Per Day`AVG_STDZD_PYMT_AMT_PER_DAY`	Average of the Total Medicare Standardized Payment Amount per Day. The Medicare Standardized Payment Amount is the total amount that Medicare paid adjusted for geographic differences in payment rates.	number
Physical Therapy Visit Count`PT_VISITS_CNT`	Number of physical therapy visits provided by the home health agency; visits identified using revenue codes 0420 to 0429.	number
Occupational Therapy Visit Count`OT_VISITS_CNT`	Number of occupational therapy visits provided by the home health agency; visits identified using revenue codes 0430 to 0439.	number
Speech Language Pathology Visit Count`SLP_VISITS_CNT`	Number of speech language pathology visits provided by the home health agency; visits identified using revenue codes 0440 to 0449.	number
Casemix Groupings for Admission Source and Timing`CASEMIX_SRC_TMNG`	Home Health Casemix Groupings for Admission Source and Timing associated with a GRPNG. Admission Source and Timing groupings include (a) Community Early (CMNTY_ERLY), (b) Institutional Early (INST_ERLY), (c) Community Late (CMNTY_LTE), and (d) Institutional Late (INST_LTE). A Health Insurance Prospective Payment System (HIPPS) code represents a set of patient characteristics or case-mix on which payment determinations are made. The first position of the HIPPS code represents the referral source and period timing on a home health claim. Community Early claims are identified with a HIPPS first position of "1". Institutional Early claims are identified with a HIPPS first position of "2". Community Late claims are identified with a HIPPS first position of "3". Institutional Late claims are identified with a HIPPS first position of "4".	string
Percent (%) of Episodes for Admission Source and Timing Casemix Grouping`CASEMIX_SRC_TMNG_EPSD_PCT`	Percent of Home-Health episodes with a particular Admission Source and Timing Casemix grouping. See CASEMIX_SRC_TIMING for descriptions of the Admission Source and Timing groups.	number
Casemix Groupings for Clinical Group and Functional Level`CASEMIX_CMRBDTY`	Home Health Clinical Group and Functional Level associated with a GRPNG. Clinical Group and Functional Levels include (a) No Comorbidity Adjustment (NO), (b) Low Comorbidity Adjustment (LOW), and (c) High Comorbidity Adjustment (HIGH). A Health Insurance Prospective Payment System (HIPPS) code represents a set of patient characteristics or case-mix on which payment determinations are made. The fourth position of the HIPPS code represents the adjustment due to comorbid diagnoses submitted as secondary diagnoses on a home health claim. No Adjustment is indicated by a HIPPS fourth position of "1". Low Adjustment is indicated by a HIPPS fourth position of "2" , and High Adjustment is indicated by a HIPPS fourth position of "3".	string
Percent (%) of Total Service Days for Clinical Group and Functional Level Casemix Grouping`CASEMIX_CMRBDTY_EPSD_PCT`	Percent of Home-Health episodes with a particular Clinical Group and Functional Level Casemix grouping. See CASEMIX_CMRBDTY for descriptions of the Clinical Group and Functional Level groups.	number

At a glance

Catalog: data.cms.gov
Publisher: Office of Enterprise Data and Analytics (OEDA)
Rows: 124,399
Columns: 33
State column: STATE
Topics: Home health and hospice, Spending and use of services, Hospitals
Contact: PDAG_Data_Products@cms.hhs.gov

API

Free, no key needed. This request returns the first 10 rows as JSON:

https://data.cms.gov/data-api/v1/dataset/6c63099b-0794-40a0-925c-51a66b9b9901/data?size=10

To keep only one state, filter on the STATE column.

Versions 11

The newest version is the one linked above. Older releases stay on the official site.

2024-01-01posted Aug 11, 2026
2023-01-02posted Jul 10, 2026
2022-01-01posted Jul 10, 2026
2021-01-01posted Jul 10, 2026
2020-01-01posted Jul 10, 2026
2019-01-01posted Jul 10, 2026
2018-01-01posted Jul 10, 2026
2017-01-01posted Jul 10, 2026

Show 3 older versions

2016-01-01posted Jul 10, 2026
2015-01-01posted Jul 10, 2026
2014-01-01posted Jul 10, 2026

CMS's description

The Medicare Post-Acute Care (PAC) Utilization - Home Health Agency (HHA) by Geography, Provider and Service supplemental dataset offers payment and utilization data for HHAs, organized by provider and Home Health Resource Group (HHRG). It reflects the 153-group HHRG model for Calendar Years (CYs) 2014 - 2019 and the expanded 432-group model for CYs 2020 - 2023 under the Home Health Prospective Payment System (HH PPS). Low Utilization Payment Adjustment (LUPA) claims are excluded from all years, as they are not assigned an HHRG and are reimbursed per visit rather than through standardized payments.

Methodology and other documents from CMS:

MUP PAC RY26 Methodology (PDF)

The summary at the top is the first sentence of this description. Record id cms:6c63099b-0794-40a0-925c-51a66b9b9901. This record as JSON.

Freshness

Columns 33

At a glance

API

Versions 11

CMS's description