OASIS-E2: The New Changes Coming April 1st Are No Joke!

Mid-Year OASIS Overhaul

The Outcome and Assessment Information Set (OASIS) is the standardized tool that U.S. home health agencies use to document patient status, drive care planning, and report quality data to the Centers for Medicare & Medicaid Services (CMS). Accurate OASIS data directly influences Medicare payment adjustments via outcome-based quality measures and star ratings.

Version E2 arrives on April 1, 2026—an off-cycle date that breaks from the usual January 1 rollouts. CMS designed this timing to implement targeted refinements without waiting for the next annual cycle, following the all-payer expansion in OASIS-E and refinements in E1.

Key revisions include replacing the transportation item (A1250) with a harmonized version (A1255) that matches items in other CMS post-acute tools, removing the COVID-19 vaccination status question (O0350) after the associated quality measure was retired, and adding hearing (B0200), vision (B1000), and language (A1110) assessments at resumption-of-care timepoints to improve risk adjustment. The gender item (M0069) shifts to sex (A0810).

These changes stem from annual rulemaking and sub-regulatory updates, including the CY 2026 Home Health Prospective Payment System rule that finalized the vaccine item removal. The mid-year switch reflects CMS's effort to phase out pandemic-era requirements and better standardize data across care settings.

Home health agencies, which serve millions of Medicare beneficiaries annually, must ensure software vendors update electronic health records and train clinicians on revised items and guidance. Errors in data collection after April 1 could trigger payment reductions under the Home Health Value-Based Purchasing model or quality reporting penalties up to 2% of Medicare reimbursements. The transition also highlights ongoing tensions between reducing provider burden and maintaining robust quality measurement, as CMS balances alignment across programs with the operational realities of mid-year changes.