Home Health Financial Benchmarks: Cost Per Visit, LUPA Rate, and Margin
The average freestanding home health agency earned a 21.2% FFS Medicare margin in 2024 while delivering just 8.4 in-person visits per 30-day period — down 18% from 2019 (MedPAC, March 2026). Those two numbers tell the whole story of home health economics right now: strong Medicare margins, achieved partly by delivering fewer visits. If you run an agency, benchmarking your own numbers against the national data is the fastest way to see whether you're leaving money on the table or carrying hidden risk. Here are the benchmarks that matter and how to read them.
Key Takeaways
The national freestanding FFS Medicare margin was 21.2% in 2024 (for-profits higher at 23.1%, nonprofits 12.2%).
Agencies average 8.4 in-person visits per full 30-day period, down from 10.2 in 2019.
LUPAs were about 7% of periods in 2024; full periods were about 93%.
The average payment per full 30-day period was $2,024 (2023); payment per visit about $237.
Cost per 30-day period rose just 0.2% in 2024 — agencies held costs flat mostly by cutting visits.
Margins scale with size: the largest-volume quintile ran 23.2% vs. 14.4% for the smallest.
The Core Benchmarks
Use these national figures as your yardstick. If your agency is far off in either direction, dig into why.
Benchmark | National figure | Source |
FFS Medicare margin (freestanding, 2024) | 21.2% | MedPAC, March 2026 |
For-profit vs. nonprofit margin | 23.1% vs. 12.2% | MedPAC, March 2026 |
Average payment per full 30-day period (2023) | $2,024 | MedPAC, March 2026 |
Medicare payment per in-person visit (2023) | $237 | MedPAC, March 2026 |
In-person visits per full 30-day period (2024) | 8.4 | MedPAC, March 2026 |
LUPA share of periods (2024) | ~7% | MedPAC, March 2026 |
Cost-per-period growth (2024) | +0.2% | MedPAC, March 2026 |
How to Read Each Benchmark
Margin
A 21.2% national margin is a benchmark, not a target you should assume you hit. Your realized margin depends on case mix, visit efficiency, and overhead. If yours is well below 21%, the usual culprits are high LUPA rates, over-visiting relative to LUPA thresholds, or heavy administrative cost. If it's well above, make sure your cost report is capturing costs accurately — understated cost is an audit risk.
Visits per period and the LUPA rate
The decline to 8.4 visits per period is the industry's main margin lever, but there is a floor: drop below a period's LUPA threshold and you lose the full case-mix payment. Track your LUPA rate monthly. A rate meaningfully above ~7% signals visit-planning or intake problems that are quietly costing revenue.
Cost per visit and per period
Because Medicare pays by period, your cost per period — not just cost per visit — determines margin. Two agencies with the same cost per visit can have very different margins if one delivers more visits per period than the payment supports.
Volume quintile (2024) | FFS Medicare margin |
Largest | 23.2% |
Smallest | 14.4% |
Scale matters: larger agencies spread overhead further. Smaller agencies can still compete, but need tighter cost control to close the ~9-point gap.
Turning Benchmarks Into Action
Build a simple monthly dashboard: margin, LUPA rate, visits per period, cost per period.
Compare each line to the national benchmark and to your own trend.
Investigate variances before year-end, while you can still act.
Reconcile the same figures to your annual Medicare cost report so your reported cost per period is accurate and defensible.
Accurate bookkeeping and cost allocation is what makes these benchmarks trustworthy — garbage in, garbage benchmark. With MedPAC recommending rate cuts, the agencies that track these numbers monthly will be the ones that stay profitable.
Benchmarking Against a Shrinking-Margin Backdrop
Read these benchmarks against where payment is heading. The CY 2027 proposed rule (CMS-1844-P) pairs a net +2.4% update with a continuing −3% clawback, and MedPAC has recommended a 7% base-rate cut. CMS also imposed a six-month moratorium on new home health enrollments effective May 13, 2026, tightening supply. A 21.2% national margin is a high-water mark, not a floor — benchmark now so you can defend margin as rates compress (CMS, CMS-1844-P, 2026; MedPAC, March 2026).
Sources
Medicare Payment Advisory Commission (MedPAC), Report to the Congress: Medicare Payment Policy, Chapter 8: Home Health Care Services, March 2026
CMS, CY 2026 Home Health PPS Final Rule (payment structure and LUPA framework)
Last updated: September 2026. Benchmarks reflect the most recent MedPAC data (2023-2024).
Soriaga & Associates, LLC is a CPA firm specializing in home health and hospice accounting. Schedule a free consultation to benchmark your agency's financials.
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