The PEPPER reports are returning as an important resource for home health and hospice providers. PEPPER, or the Program for Evaluating Payment Patterns Electronic Reports, has long helped agencies evaluate their billing patterns and identify potential areas of risk. After the PEPPER portal was taken offline in late 2023, the reports were unavailable while CMS reviewed how providers use the data and evaluated opportunities to improve the reports. With their return, agencies once again have access to valuable benchmarking information that can support compliance efforts and help identify potential areas for further review.
In June 2026, the Hospice PEPPER reports became available again for providers. Access to these reports is restricted to authorized users, so agencies must have the appropriate login credentials to view their organization’s data. The Home Health PEPPER reports are expected to be released in mid-September 2026, giving home health agencies access to their updated performance information as well.
The PEPPER reports are generated using data submitted on your home health and hospice Medicare claims. For home health agencies, the reports are based solely on claims data and do not include OASIS information. Likewise, hospice PEPPER reports do not incorporate HOPE data. Instead, the reports analyze the claims submitted for payment and calculate results using a series of measures and target areas developed specifically for home health and hospice providers.
The Hospice PEPPER reports released in June 2026 include several updates. Changes were made to the diagnosis code reporting section, and the Continuous Home Care in an Assisted Living Facility target was removed. The reports also now include measures related to Medicare Part B and Part D spending. These additions align with the increased focus on utilization and spending patterns discussed in recent hospice payment updates. Within the PEPPER report, agencies can review Part B spending for services provided in both facility and home settings, as well as Part D spending data, providing additional insight into these areas.
PEPPER data is used by CMS contractors and other medical review entities, including Medicare MACS, as one tool to identify agencies whose billing patterns differ significantly from other home health and hospice agencies in the country. The reports compare your agency’s results against national benchmarks for each target area. Agencies with results at or above the 80th percentile for a particular measure are considered outliers, which may indicate an area that warrants additional review.
Agencies identified as outliers in one or more PEPPER target areas may be more likely to be selected for some type of medical review. It is not uncommon for an agency to exceed the 80th percentile in one or two target areas without being an outlier across all measures. For that reason, agencies should review each target individually, understand the factors contributing to their results, and determine whether any changes to documentation, coding, or billing practices are appropriate.
For hospice agencies, it is important to access your PEPPER reports and become familiar with the information they contain. Reviewing your results can help you identify potential areas of concern, better understand your agency’s performance compared to national benchmarks, and proactively address issues before they receive additional attention during the current medical review environment.
Home health agencies are also facing increased regulatory oversight. Once the Home Health PEPPER reports are released in September, agencies should access their reports as soon as they become available and carefully review the results. Understanding how your agency compares to national benchmarks can help identify potential risk areas, support proactive compliance efforts, and better prepare your organization for the possibility of future medical reviews.
Healthcare Provider Solutions is here to help you interpret and evaluate your PEPPER reports, identify potential areas of risk, and provide guidance on any medical review issues that may impact your agency. If you need assistance understanding your results or preparing for a review, our team is ready to support you, please reach out to us.
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