CMS has released the 2025 Comprehensive Error Rate Testing (CERT) Report, showing the Medicare FFS improper payment rate has declined to 6.55%, the lowest since 2021. 

Home health and hospice together account for 9.8% of overall Medicare FFS improper payments, with documentation and medical‑necessity issues continuing to drive most errors.

 

CMS calculated an improper payment rate of 6.1%  ($1.7B). Top causes included documentation that did not support medical necessity, missing or inadequate physician certifications/recertifications, insufficient documentation for service-intensity add-ons, absent face-to-face encounters, missing physician narratives, and no documentation submitted.

 

CMS calculated an improper payment rate of 6.9% ($1.07B). Errors closely mirrored hospice, with insufficient documentation, medical‑necessity concerns, and claims lacking any documentation.

 

For both home health and hospice, insufficient documentation and medical‑necessity errors remain the primary drivers of improper payments, reinforcing the need for complete certifications, accurate assessments, and thorough clinical documentation.

 

CERT findings highlight the importance of tightening documentation practices through targeted internal audits and staff training, with particular attention to medical necessity, physician narratives, F2F compliance, and certification elements.