{ "meta": { "title": "Home Health Cost Report Benchmarks", "description": "Aggregate benchmarks (cost per visit by discipline, visit volume, payer mix, operating and Medicare margins) for Medicare-certified home health agencies, built from the CMS data.cms.gov cost report files.", "credit": "Soriaga & Associates, LLC", "credit_url": "https://www.soriagacpa.com/home-health-cost-report-benchmarks", "license": "CC BY 4.0", "license_url": "https://creativecommons.org/licenses/by/4.0/", "sources": [ { "name": "data.cms.gov Home Health Agency Cost Report, file year 2020 (CSV)", "url": "https://data.cms.gov/sites/default/files/2026-09/77f9d993-c2de-4e44-b55f-51be1ff4fe48/CostReporthha_Final_20.csv", "kind": "data", "cms_last_updated": "2026-09-30", "retrieved": "2026-10-22" }, { "name": "data.cms.gov Home Health Agency Cost Report, file year 2021 (CSV)", "url": "https://data.cms.gov/sites/default/files/2026-10/ff7852bf-71e4-4d9f-838b-413062d96687/CostReporthha_Final_21.csv", "kind": "data", "cms_last_updated": "2026-10-05", "retrieved": "2026-10-22" }, { "name": "data.cms.gov Home Health Agency Cost Report, file year 2022 (CSV)", "url": "https://data.cms.gov/sites/default/files/2026-10/8662949d-ea6b-44a0-a9b8-e59712326b16/CostReporthha_Final_22.csv", "kind": "data", "cms_last_updated": "2026-10-05", "retrieved": "2026-10-22" }, { "name": "data.cms.gov Home Health Agency Cost Report, file year 2023 (CSV)", "url": "https://data.cms.gov/sites/default/files/2026-10/ce1d6b88-cdcd-49d5-a091-7f245370b545/CostReporthha_Final_23.csv", "kind": "data", "cms_last_updated": "2026-10-05", "retrieved": "2026-10-22" }, { "name": "data.cms.gov Home Health Agency Cost Report, file year 2024 (CSV)", "url": "https://data.cms.gov/sites/default/files/2026-09/8ee21209-1a1f-4564-abfb-b83d2fef37a8/CostReport_HHA_2024.csv", "kind": "data", "cms_last_updated": "2026-09-30", "retrieved": "2026-10-22" }, { "name": "data.cms.gov Home Health Agency Cost Report (landing page)", "url": "https://data.cms.gov/provider-compliance/cost-reports/home-health-agency-cost-report", "kind": "documentation", "cms_last_updated": null, "retrieved": null }, { "name": "data.cms.gov Home Health Agency Cost Report data dictionary", "url": "https://data.cms.gov/resources/home-health-agency-cost-report-data-dictionary", "kind": "documentation", "cms_last_updated": null, "retrieved": null }, { "name": "data.cms.gov Home Health Agency Cost Report methodology", "url": "https://data.cms.gov/resources/home-health-agency-cost-report-methodology", "kind": "documentation", "cms_last_updated": null, "retrieved": null } ], "form": "CMS-1728-20 (Home Health Agency Cost Report)", "year_definition": "CMS's data.cms.gov file year (2020 to 2024). Each yearly file holds cost reports whose periods mostly begin in that calendar year; it is not a uniform fiscal year.", "years": [ 2020, 2021, 2022, 2023, 2024 ], "latest_complete_year": 2024, "generated_at": "2026-10-22T16:03:45Z", "tool_version": "0.1.0", "counts": { "2020": { "raw": 9447, "excluded_no_financial_data": 2494, "excluded_no_cost_or_days": 0, "excluded_partial_year": 54, "dropped_duplicates": 0, "kept": 6899, "raw_rows_sharing_a_ccn": 0, "data_checks": { "margin_no_positive_revenue": 115, "medicare_margin_not_computable": 22, "no_state_group": 7 }, "raw_data_checks": {}, "metric_screening": { "cost_per_visit_rn": { "values": 6882, "range_excluded": 0, "outlier_excluded": 138, "p01": 45.3872, "p99": 1228.5922 }, "cost_per_visit_lpn": { "values": 4592, "range_excluded": 0, "outlier_excluded": 92, "p01": 24.4948, "p99": 1378.5096 }, "cost_per_visit_pt": { "values": 6857, "range_excluded": 0, "outlier_excluded": 138, "p01": 62.068, "p99": 1174.0536 }, "cost_per_visit_pta": { "values": 4152, "range_excluded": 0, "outlier_excluded": 84, "p01": 24.1492, "p99": 828.7116 }, "cost_per_visit_ot": { "values": 6366, "range_excluded": 0, "outlier_excluded": 128, "p01": 37.155, "p99": 1202.915 }, "cost_per_visit_ota": { "values": 3040, "range_excluded": 0, "outlier_excluded": 62, "p01": 15.3379, "p99": 832.5631 }, "cost_per_visit_slp": { "values": 5447, "range_excluded": 0, "outlier_excluded": 110, "p01": 30.4984, "p99": 1310.0516 }, "cost_per_visit_msw": { "values": 5069, "range_excluded": 0, "outlier_excluded": 102, "p01": 22.1212, "p99": 3619.7024 }, "cost_per_visit_hha": { "values": 6147, "range_excluded": 0, "outlier_excluded": 124, "p01": 10.1558, "p99": 1569.3666 }, "total_visits": { "values": 6899, "range_excluded": 0, "outlier_excluded": 138, "p01": 326.82, "p99": 195373.56 }, "medicare_share_visits": { "values": 6899, "range_excluded": 0, "outlier_excluded": 0, "screen_not_applied": true }, "operating_margin": { "values": 6531, "range_excluded": 253, "outlier_excluded": 132, "p01": -0.761, "p99": 0.4853 }, "medicare_margin_cost_based": { "values": 6667, "range_excluded": 210, "outlier_excluded": 134, "p01": -0.7266, "p99": 0.7838 } }, "complete": true }, "2021": { "raw": 10403, "excluded_no_financial_data": 3078, "excluded_no_cost_or_days": 0, "excluded_partial_year": 159, "dropped_duplicates": 0, "kept": 7166, "raw_rows_sharing_a_ccn": 168, "data_checks": { "margin_no_positive_revenue": 121, "medicare_margin_not_computable": 21, "no_state_group": 7 }, "raw_data_checks": {}, "metric_screening": { "cost_per_visit_rn": { "values": 7151, "range_excluded": 0, "outlier_excluded": 144, "p01": 45.74, "p99": 1232.05 }, "cost_per_visit_lpn": { "values": 5111, "range_excluded": 0, "outlier_excluded": 104, "p01": 21.372, "p99": 1105.209 }, "cost_per_visit_pt": { "values": 7121, "range_excluded": 0, "outlier_excluded": 144, "p01": 61.746, "p99": 1193.534 }, "cost_per_visit_pta": { "values": 4741, "range_excluded": 0, "outlier_excluded": 96, "p01": 22.294, "p99": 825.418 }, "cost_per_visit_ot": { "values": 6556, "range_excluded": 0, "outlier_excluded": 132, "p01": 36.1425, "p99": 1410.0095 }, "cost_per_visit_ota": { "values": 3403, "range_excluded": 0, "outlier_excluded": 70, "p01": 11.0048, "p99": 941.2382 }, "cost_per_visit_slp": { "values": 5575, "range_excluded": 0, "outlier_excluded": 112, "p01": 25.852, "p99": 1272.6538 }, "cost_per_visit_msw": { "values": 5135, "range_excluded": 0, "outlier_excluded": 104, "p01": 15.1904, "p99": 4040.2328 }, "cost_per_visit_hha": { "values": 6145, "range_excluded": 0, "outlier_excluded": 124, "p01": 8.2232, "p99": 1889.202 }, "total_visits": { "values": 7166, "range_excluded": 0, "outlier_excluded": 144, "p01": 255.6, "p99": 189614.5 }, "medicare_share_visits": { "values": 7166, "range_excluded": 0, "outlier_excluded": 0, "screen_not_applied": true }, "operating_margin": { "values": 6731, "range_excluded": 314, "outlier_excluded": 136, "p01": -0.798, "p99": 0.4914 }, "medicare_margin_cost_based": { "values": 6909, "range_excluded": 236, "outlier_excluded": 140, "p01": -0.7711, "p99": 0.7661 } }, "complete": true }, "2022": { "raw": 10655, "excluded_no_financial_data": 3343, "excluded_no_cost_or_days": 0, "excluded_partial_year": 142, "dropped_duplicates": 0, "kept": 7170, "raw_rows_sharing_a_ccn": 162, "data_checks": { "margin_no_positive_revenue": 125, "medicare_margin_not_computable": 17, "no_state_group": 7 }, "raw_data_checks": {}, "metric_screening": { "cost_per_visit_rn": { "values": 7156, "range_excluded": 0, "outlier_excluded": 144, "p01": 47.588, "p99": 1324.872 }, "cost_per_visit_lpn": { "values": 5308, "range_excluded": 0, "outlier_excluded": 108, "p01": 27.4903, "p99": 1209.2677 }, "cost_per_visit_pt": { "values": 7123, "range_excluded": 0, "outlier_excluded": 144, "p01": 58.1242, "p99": 1342.2664 }, "cost_per_visit_pta": { "values": 4916, "range_excluded": 0, "outlier_excluded": 100, "p01": 28.2965, "p99": 773.837 }, "cost_per_visit_ot": { "values": 6471, "range_excluded": 0, "outlier_excluded": 130, "p01": 35.98, "p99": 1194.333 }, "cost_per_visit_ota": { "values": 3515, "range_excluded": 0, "outlier_excluded": 72, "p01": 17.737, "p99": 931.2162 }, "cost_per_visit_slp": { "values": 5405, "range_excluded": 0, "outlier_excluded": 110, "p01": 27.1012, "p99": 1425.282 }, "cost_per_visit_msw": { "values": 4989, "range_excluded": 0, "outlier_excluded": 100, "p01": 28.4556, "p99": 4198.8168 }, "cost_per_visit_hha": { "values": 5926, "range_excluded": 0, "outlier_excluded": 120, "p01": 11.0675, "p99": 2800.965 }, "total_visits": { "values": 7170, "range_excluded": 0, "outlier_excluded": 144, "p01": 260.38, "p99": 185997.87 }, "medicare_share_visits": { "values": 7170, "range_excluded": 0, "outlier_excluded": 0, "screen_not_applied": true }, "operating_margin": { "values": 6725, "range_excluded": 320, "outlier_excluded": 136, "p01": -0.8288, "p99": 0.5014 }, "medicare_margin_cost_based": { "values": 6914, "range_excluded": 239, "outlier_excluded": 140, "p01": -0.7669, "p99": 0.7832 } }, "complete": true }, "2023": { "raw": 10778, "excluded_no_financial_data": 3423, "excluded_no_cost_or_days": 0, "excluded_partial_year": 97, "dropped_duplicates": 0, "kept": 7258, "raw_rows_sharing_a_ccn": 127, "data_checks": { "margin_no_positive_revenue": 138, "medicare_margin_not_computable": 20, "no_state_group": 6 }, "raw_data_checks": {}, "metric_screening": { "cost_per_visit_rn": { "values": 7244, "range_excluded": 0, "outlier_excluded": 146, "p01": 51.7043, "p99": 1663.4773 }, "cost_per_visit_lpn": { "values": 5450, "range_excluded": 0, "outlier_excluded": 110, "p01": 30.4588, "p99": 1070.3872 }, "cost_per_visit_pt": { "values": 7212, "range_excluded": 0, "outlier_excluded": 146, "p01": 62.2976, "p99": 1245.3402 }, "cost_per_visit_pta": { "values": 5005, "range_excluded": 0, "outlier_excluded": 102, "p01": 28.0484, "p99": 787.0076 }, "cost_per_visit_ot": { "values": 6478, "range_excluded": 0, "outlier_excluded": 130, "p01": 37.7435, "p99": 1233.5074 }, "cost_per_visit_ota": { "values": 3571, "range_excluded": 0, "outlier_excluded": 72, "p01": 16.994, "p99": 1214.086 }, "cost_per_visit_slp": { "values": 5322, "range_excluded": 0, "outlier_excluded": 108, "p01": 26.8886, "p99": 1562.0102 }, "cost_per_visit_msw": { "values": 4930, "range_excluded": 0, "outlier_excluded": 100, "p01": 24.7359, "p99": 4005.3804 }, "cost_per_visit_hha": { "values": 5816, "range_excluded": 0, "outlier_excluded": 118, "p01": 11.057, "p99": 2706.7465 }, "total_visits": { "values": 7258, "range_excluded": 0, "outlier_excluded": 146, "p01": 247.85, "p99": 192108.38 }, "medicare_share_visits": { "values": 7258, "range_excluded": 0, "outlier_excluded": 0, "screen_not_applied": true }, "operating_margin": { "values": 6809, "range_excluded": 311, "outlier_excluded": 138, "p01": -0.7818, "p99": 0.5025 }, "medicare_margin_cost_based": { "values": 6983, "range_excluded": 255, "outlier_excluded": 140, "p01": -0.7331, "p99": 0.7425 } }, "complete": true }, "2024": { "raw": 10970, "excluded_no_financial_data": 3497, "excluded_no_cost_or_days": 0, "excluded_partial_year": 187, "dropped_duplicates": 0, "kept": 7286, "raw_rows_sharing_a_ccn": 176, "data_checks": { "margin_no_positive_revenue": 117, "medicare_margin_not_computable": 22, "no_state_group": 6 }, "raw_data_checks": {}, "metric_screening": { "cost_per_visit_rn": { "values": 7275, "range_excluded": 0, "outlier_excluded": 146, "p01": 54.2506, "p99": 1503.319 }, "cost_per_visit_lpn": { "values": 5575, "range_excluded": 0, "outlier_excluded": 112, "p01": 25.9482, "p99": 1277.8186 }, "cost_per_visit_pt": { "values": 7232, "range_excluded": 0, "outlier_excluded": 146, "p01": 62.8662, "p99": 1398.9683 }, "cost_per_visit_pta": { "values": 5064, "range_excluded": 0, "outlier_excluded": 102, "p01": 24.4446, "p99": 1052.0992 }, "cost_per_visit_ot": { "values": 6416, "range_excluded": 0, "outlier_excluded": 130, "p01": 30.4985, "p99": 1533.3225 }, "cost_per_visit_ota": { "values": 3553, "range_excluded": 0, "outlier_excluded": 72, "p01": 14.6408, "p99": 1514.2752 }, "cost_per_visit_slp": { "values": 5173, "range_excluded": 0, "outlier_excluded": 104, "p01": 24.8972, "p99": 1814.9996 }, "cost_per_visit_msw": { "values": 4840, "range_excluded": 0, "outlier_excluded": 98, "p01": 17.6218, "p99": 5663.1975 }, "cost_per_visit_hha": { "values": 5755, "range_excluded": 0, "outlier_excluded": 116, "p01": 11.7194, "p99": 2631.8942 }, "total_visits": { "values": 7286, "range_excluded": 0, "outlier_excluded": 146, "p01": 374.95, "p99": 187656.7 }, "medicare_share_visits": { "values": 7286, "range_excluded": 0, "outlier_excluded": 0, "screen_not_applied": true }, "operating_margin": { "values": 6873, "range_excluded": 296, "outlier_excluded": 138, "p01": -0.7782, "p99": 0.489 }, "medicare_margin_cost_based": { "values": 7032, "range_excluded": 232, "outlier_excluded": 142, "p01": -0.718, "p99": 0.7367 } }, "complete": true } }, "notes": [ "Cost reports are provider-filed and may be unaudited.", "The data mixes reports at different CMS statuses (as submitted, settled, reopened) because CMS keeps the highest status per report.", "All-payer operating margins include costs that Medicare does not allow.", "Partial-year reports (period under 300 or over 430 days) are excluded.", "The newest years are incomplete and fill in over time; see counts and latest_complete_year.", "Figures are not risk-adjusted or wage-adjusted.", "Cells with fewer than 11 agencies are suppressed. No provider-level data is published.", "About a third of rows in the CMS files have no financial data (blank Total Cost) and are excluded.", "Medicare PPS payments are the four 'Total PPS Payment' episode columns plus the two 'Total PPS Outlier Payment' columns (Wkst D lines 10 to 15; PRM 15-2 section 4715.2).", "Share metrics have a pooled value (total numerator over total denominator); per-agency medians can hide small levels of care." ], "disclaimer": "General information from public CMS filings, not an audit, valuation, or advice for any agency." }, "metrics": [ { "id": "cost_per_visit_rn", "label": "Cost per visit, skilled nursing (RN)", "unit": "usd_per_visit", "definition": "Average cost per skilled nursing (RN) visit, only for agencies that report this discipline.", "source_fields": [ "data.cms.gov column 'Skilled Nursing Care-RN, Avg Cost Per Visit' (Wkst C Part I col 4)" ], "has_pooled": false, "pooled_only": false }, { "id": "cost_per_visit_lpn", "label": "Cost per visit, skilled nursing (LPN)", "unit": "usd_per_visit", "definition": "Average cost per skilled nursing (LPN) visit, only for agencies that report this discipline.", "source_fields": [ "data.cms.gov column 'Skilled Nursing Care-LPN, Avg Cost Per Visit' (Wkst C Part I col 4)" ], "has_pooled": false, "pooled_only": false }, { "id": "cost_per_visit_pt", "label": "Cost per visit, physical therapy", "unit": "usd_per_visit", "definition": "Average cost per physical therapy visit, only for agencies that report this discipline.", "source_fields": [ "data.cms.gov column 'Physical Therapy, Avg Cost Per Visit' (Wkst C Part I col 4)" ], "has_pooled": false, "pooled_only": false }, { "id": "cost_per_visit_pta", "label": "Cost per visit, physical therapy assistant", "unit": "usd_per_visit", "definition": "Average cost per physical therapy assistant visit, only for agencies that report this discipline.", "source_fields": [ "data.cms.gov column 'Physical Therapy Asst, Avg Cost Per Visit' (Wkst C Part I col 4)" ], "has_pooled": false, "pooled_only": false }, { "id": "cost_per_visit_ot", "label": "Cost per visit, occupational therapy", "unit": "usd_per_visit", "definition": "Average cost per occupational therapy visit, only for agencies that report this discipline.", "source_fields": [ "data.cms.gov column 'Occupational Therapy, Avg Cost Per Visit' (Wkst C Part I col 4)" ], "has_pooled": false, "pooled_only": false }, { "id": "cost_per_visit_ota", "label": "Cost per visit, occupational therapy assistant", "unit": "usd_per_visit", "definition": "Average cost per occupational therapy assistant visit, only for agencies that report this discipline.", "source_fields": [ "data.cms.gov column 'Occupational Therapy Asst, Avg Cost Per Visit' (Wkst C Part I col 4)" ], "has_pooled": false, "pooled_only": false }, { "id": "cost_per_visit_slp", "label": "Cost per visit, speech-language pathology", "unit": "usd_per_visit", "definition": "Average cost per speech-language pathology visit, only for agencies that report this discipline.", "source_fields": [ "data.cms.gov column 'Speech-Language-Path, Avg Cost Per Visit' (Wkst C Part I col 4)" ], "has_pooled": false, "pooled_only": false }, { "id": "cost_per_visit_msw", "label": "Cost per visit, medical social service", "unit": "usd_per_visit", "definition": "Average cost per medical social service visit, only for agencies that report this discipline.", "source_fields": [ "data.cms.gov column 'Medical Social Service, Avg Cost Per Visit' (Wkst C Part I col 4)" ], "has_pooled": false, "pooled_only": false }, { "id": "cost_per_visit_hha", "label": "Cost per visit, home health aide", "unit": "usd_per_visit", "definition": "Average cost per home health aide visit, only for agencies that report this discipline.", "source_fields": [ "data.cms.gov column 'Home Health Aide, Avg Cost Per Visit' (Wkst C Part I col 4)" ], "has_pooled": false, "pooled_only": false }, { "id": "total_visits", "label": "Total visits per agency", "unit": "count", "definition": "Total visits, all disciplines and payers.", "source_fields": [ "data.cms.gov column 'Total, Total Visits'" ], "has_pooled": false, "pooled_only": false }, { "id": "medicare_share_visits", "label": "Medicare share of visits", "unit": "ratio", "definition": "Each agency's Title XVIII (Medicare) visits divided by its total visits. Quartiles and mean are across agencies. The pooled value is total Medicare visits divided by total visits across all agencies in the group.", "source_fields": [ "data.cms.gov columns 'Total, Medicare Title XVIII Visits' / 'Total, Total Visits'" ], "has_pooled": true, "pooled_only": false }, { "id": "operating_margin", "label": "All-payer operating margin", "unit": "ratio", "definition": "(Net patient revenue minus total operating expenses) divided by net patient revenue. Only where net patient revenue is above zero; margins outside -100% to +100% are excluded as data errors.", "source_fields": [ "data.cms.gov columns 'Net Patient Revenues (line 1 minus line 2) Total' (F-1 line 3) and 'Less Total Operating Expenses (sum of lines 4 through 16)' (F-1 line 17)" ], "has_pooled": false, "pooled_only": false }, { "id": "medicare_margin_cost_based", "label": "Cost-based Medicare margin", "unit": "ratio", "definition": "(Medicare PPS payments minus total HHA Medicare program cost) divided by Medicare PPS payments. Payments are the sum of the four 'Total PPS Payment' episode columns and the two 'Total PPS Outlier Payment' columns (Wkst D lines 10 to 15), not adjusted for bad debts or sequestration. Margins outside -100% to +100% are excluded as data errors.", "source_fields": [ "data.cms.gov columns 'Total PPS Payment - full episodes/periods without outliers'; 'Total PPS Payment - full episodes/periods with outliers'; 'Total PPS Payment - LUPA episodes/periods'; 'Total PPS Payment - PEP episodes/periods'; 'Total PPS Outlier Payment - full episodes/periods with outliers'; 'Total PPS Outlier Payment - PEP episodes/periods'; 'Total HHA Medicare Program Cost'" ], "has_pooled": false, "pooled_only": false } ], "rows": [ { "group_type": "national", "group": "US", "year": 2020, "metric": "cost_per_visit_rn", "n": 6744, "p25": 134.83, "median": 179.02, "p75": 248.3, "mean": 215.76, "pooled": null, "suppressed": false }, { "group_type": "national", "group": "US", "year": 2020, "metric": "cost_per_visit_lpn", "n": 4500, "p25": 73.66, "median": 105.24, "p75": 155.33, "mean": 134.7, "pooled": null, "suppressed": false }, { "group_type": "national", "group": "US", "year": 2020, "metric": 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