Home health and hospice dates to know through January 2027: HETS emails, the hospice addendum, appeal thresholds and more

The last quarter of 2026 brings several administrative dates for home health and hospice agencies. Here they are in date order, as of October 19, 2026. Some are national, and others come from a single MAC, so check who each notice covers.

Already passed: HHCAHPS second-quarter data

The Home Health CAHPS (HHCAHPS) data submission deadline for the second quarter of 2026 was October 15, according to the survey's deadline table. The next one listed is January 21, 2027, for the third quarter.

October 21 to December 18: Palmetto GBA phone-line closures (JM, including Illinois)

Palmetto GBA lists Provider Contact Center closures for training and holidays. The notice's table gives clock times without naming a time zone in the text we could read; we have assumed Eastern, since Palmetto's other hours on the same page are Eastern. Central times are in parentheses. Confirm with Palmetto before relying on them:

• October 21, November 11 and December 11: 12:30 to 4:30 p.m. ET (11:30 a.m. to 3:30 p.m. CT)
• November 20: 8 a.m. to noon ET (7 to 11 a.m. CT)
• December 18: noon to 4:30 p.m. ET (11 a.m. to 3:30 p.m. CT)
• Offices closed November 26 and 27, and December 24 and 25

October 31: CGS's extended DDE and PPTN recertification (J15)

CGS says about 2,700 DDE and PPTN users did not recertify by the September 30 deadline, so it extended the deadline to October 31. CGS says that once termination begins, restoring access takes a new application, with the normal 20 business days for processing.

November 2: "allowed practitioners" in the Program Integrity Manual

Transmittal R13972PI (Change Request 14627) updates the home health sections of chapter 6 of the Medicare Program Integrity Manual, effective November 2. It reflects section 3708 of the 2020 CARES Act, which allows nurse practitioners, clinical nurse specialists and physician assistants to order and certify patients for the Medicare home health benefit and establish the plan of care. The revised sections now read "physician or allowed practitioner," and the transmittal tells contractors to accept documentation from those practitioners.

November 11: hospice CAHPS Q2 data due

Survey vendors are responsible for submitting CAHPS Hospice Survey data for patients who died in April, May and June (second quarter 2026) by 8 p.m. ET (7 p.m. CT) on November 11, according to the survey's official site. The site advises allowing time in case resubmissions are needed. More in our quality reporting brief.

December 1: HETS enrollment emails must work

According to CMS's October 8 MLN Connects, providers who check Medicare eligibility through the HIPAA Eligibility Transaction System (HETS) 270/271 via a software vendor, billing company, EHR or clearinghouse should make sure the email address on their HETS EDI enrollment is correct by December 1. If email to that address fails to deliver three months in a row (October 1, November 1 and December 1), HETS will suspend the enrollment and reject all eligibility requests for the provider's NPI until the address is corrected through the MAC. CMS says a billing company, EHR vendor or clearinghouse can't make that change for the provider.

December 31: the hospice addendum enforcement-discretion window ends

For hospice elections that start on or after October 1, hospices must give each beneficiary the election statement addendum. From October 1 through December 31, CMS is using enforcement discretion: MACs won't deny claims solely because the addendum is missing or incomplete and will focus on educating hospices (MLN Connects, October 1). After that, the addendum is a condition of payment again.

January 1, 2027: new appeal threshold for federal court

Per CGS, the amount in controversy needed for an administrative law judge hearing stays at $200 for requests filed on or after January 1, 2027. For federal district court review, it rises from $1,960 to $2,000 for requests filed on or after that date.

January 1 and 4, 2027: claims updates

The home health consolidated billing code list changes January 1 (our story). The quarterly Home Health Grouper update for January 2027, transmittal R13974CP, takes effect January 1, and MAC systems implement it January 4.

Sources

• CAHPS Hospice Survey, What's New
• CMS, MLN Connects, October 8, 2026
• CMS, MLN Connects, October 1, 2026
• CMS, transmittal R13972PI (PDF)
• HHCAHPS, data submission deadlines
• CMS, transmittal R13974CP (PDF)
• CGS, DDE & PPTN recertification
• CGS, 2027 amount in controversy
• Palmetto GBA, Provider Contact Center closures

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It is general information, not clinical, billing or legal advice.*

Drafted with AI assistance from primary sources and reviewed by Monsaur Othman before publication. Read how we use AI, our editorial policy and our corrections policy.

Informational only, not billing, legal or clinical advice. Check the linked primary source and your Medicare Administrative Contractor.