The Veterans Affairs administration has released its 2026 reimbursement rates, following its annual review each November–December. While most states will see no change in home care reimbursement, two states were hit with significant reductions:

Texas: 43% cut to home care rates

New Mexico: 19% cut to home care rates

For Massachusetts providers, rates for 2026 remain unchanged across all listed home care and adult day services.

To support your planning, we’ve arranged access to a free, interactive rate-lookup tool from Paradigm, allowing you to review the updated 2026 VA rates by ZIP code and service area. Check 

Your 2026 VA Rates Here:

https://www.paradigmseniors.com/feescheduleaccess

How VA Determines Payment Rates

When reimbursing authorized community care services, the VA applies rates using the following order of priority:

Contract-Negotiated Rate – If a provider has a VA contract, that rate applies first.

Medicare Rate – If no contract rate exists, VA uses CMS-published Medicare rates, including MAC rates.

VA Fee Schedule Rate (VAFS) – Applied when neither a contract nor Medicare rate is available.

Percentage of Billed Charges – Used only if no other rate applies.

Key Programs Not Covered by the VA Fee Schedule

Some VA programs follow separate reimbursement structures:

CHAMPVA operates under its own billing and reimbursement rules.

Dental Services use proprietary rates and require coordination with the appropriate third-party administrator (TPA) or referring VA Medical Center (VAMC).

Important Reimbursement Considerations for Providers

Published rates do not imply coverage. Rates apply only if a service is authorized.

VA only reimburses authorized services. Providers must confirm that care aligns exactly with the VA-approved referral.

Referral type matters. Reimbursement may differ based on how care was approved.

Payment may be capped. VA may reimburse the lesser of the billed amount or the allowable rate.

Alaska providers follow separate rules. These do not apply to Massachusetts agencies.

How to Identify the Correct VA Fee Schedule Rate

Providers should follow these steps:

Open the applicable VA Fee Schedule file

Identify the service code and any modifiers

Confirm the Medicare locality and carrier for the service location

Determine whether care was delivered in a facility or non-facility setting

Use the corresponding Facility or Non-Facility rate column

Bottom Line for Massachusetts Providers

For 2026, Massachusetts home care and adult day providers will see no rate changes under the VA Fee Schedule. While rates remain flat, providers should continue to:

Verify all services are explicitly authorized

Review contracts carefully

Monitor updates annually for future changes