How long home health lasts: periods, recertification and discharge

Families often ask how many visits Medicare allows. There isn’t a set number. Home health continues while the person still qualifies, and a doctor or allowed provider looks at that question again at least every 60 days.^1,2 This note explains how the timing works, why someone doesn’t have to be getting better to keep getting care, how home health ends, and what to do if you think it’s ending too soon.

The short answer

• There’s no set number of visits. Medicare pays agencies in 30-day periods, and a person can have more than one.¹
• A doctor or allowed provider recertifies the need for home health at least every 60 days, and the plan of care is reviewed at least that often.^2,3
• After a hospital stay of 24 hours or more, the agency reassesses the person within 48 hours of their coming home.⁴
• The person doesn’t have to be improving. Skilled care to keep someone stable or slow a decline can be covered too.⁵
• Home health ends when the goals are met, when Medicare or another payer will no longer pay, or when the person chooses to stop.⁶
• At least 2 days before covered care ends, the agency gives a Notice of Medicare Non-Coverage, which explains how to ask for a fast appeal.¹

How the timing works

Home health runs on two clocks. The first is the plan of care. A doctor or allowed provider certifies that the person needs home health, then recertifies it at least every 60 days for as long as care continues.² The plan itself is reviewed as often as the person’s condition requires, and at least every 60 days.³

During the last 5 days of each 60, a nurse or therapist reassesses the person to see what they still need.⁴ That reassessment and the doctor’s review decide whether care goes on for another 60 days.

The second clock is how Medicare pays. It pays agencies in 30-day periods, and a person can have more than one in a row.¹ Families don’t need to track it, but it’s why you may hear the word period from the agency.

In one picture

Home health runs on two clocks.

the plan of careat least every 60 days

how Medicare pays30-day periods

0306090120days

the last 5 days of each 60

Sources · law.cornell.edu, es.medicare.gov

If the person goes back to the hospital

A hospital stay interrupts home health. When the person comes home after a stay of 24 hours or more, for anything other than tests, the agency reassesses them within 48 hours, or on the date the doctor orders, and updates the plan.⁴ Call the agency as soon as you know the person is going in, and again when you know the day they’re coming home.

Getting better isn’t required

Some families are told care has to stop because the person isn’t improving. That isn’t Medicare’s rule. In a 2013 court settlement, Jimmo v. Sebelius, Medicare confirmed that a person’s potential to improve isn’t the deciding factor for skilled nursing and therapy, in home health and in other settings.⁵ Someone may need skilled care to keep from getting worse or to keep the abilities they have, and that care can be covered when it takes a nurse’s or therapist’s skill.⁵

The rule cuts the other way too. Care that someone without a nurse’s or therapist’s training could safely give isn’t covered, whether or not the person is improving.⁵

When home health ends

Under Medicare’s rules, an agency can end care or transfer the person only for these reasons:⁶

• The goals in the plan are met, and the doctor and the agency agree the person no longer needs home health
• Medicare or another payer will no longer pay for it
• The person refuses care or chooses to leave the agency
• The person’s needs are more than the agency can meet, and it arranges a safe transfer
• Behavior in the home is seriously disruptive, abusive or uncooperative, and the agency has first tried to resolve it
• The person dies, or the agency closes

The person can also leave any time. Choosing a different agency is a transfer, and Medicare pays only one agency at a time.¹

The notices before care ends or changes

The person has the right to written notice before care is cut back or ended.⁶ Three Medicare notices cover it:¹

• Notice of Medicare Non-Coverage. Given at least 2 days before all covered home health services end. It states the end date and how to ask for a fast appeal.
• Home Health Change of Care Notice. Given before the agency reduces or stops some services or supplies, such as when the agency makes a business decision or the doctor’s orders aren’t renewed.
• Advance Beneficiary Notice. Given before a service or supply Medicare probably won’t cover, so the person can decide whether to get it and pay for it.

How to ask for a fast appeal

If the person thinks covered care is ending too soon, they can ask an independent reviewer, called a Beneficiary and Family Centered Care Quality Improvement Organization, for a fast appeal. Ask before the services end, and follow the steps on the notice.¹ In California, that reviewer is Livanta, at (877) 588-1123.⁷ For help, call 1-800-MEDICARE.¹

If the reviewer decides care should continue, Medicare may keep paying for it. If it decides coverage should end, the person pays for any care after the end date on the notice.¹

Leaving well

Good home health plans for its own ending. The plan of care includes teaching the person and family what they need to manage after discharge.³ When someone moves on to another agency, a skilled nursing facility or a rehabilitation facility, the agency has to help them choose and send the next provider the medical information it needs, with the person’s goals and preferences.⁸

Before the last visit, ask what to watch for, who to call now, when the next doctor’s appointment is and what happens to the equipment. If needs grow later, home health can start again with a new order from a doctor or allowed provider, as long as the person qualifies.¹

Questions families ask

Is there a limit on how long Medicare pays for home health?

There’s no set limit. Care continues in 30-day periods while the person still qualifies, and the doctor or allowed provider recertifies it at least every 60 days.^1,2

The agency says Dad has plateaued. Does care have to stop?

Not for that reason alone. Medicare coverage of skilled nursing and therapy doesn’t depend on improvement, and skilled care to keep him stable or slow a decline can be covered.⁵

What happens to home health if Mom goes back into the hospital?

When she comes home after a stay of 24 hours or more, the agency reassesses her within 48 hours, or on the date her doctor orders, and updates the plan.⁴

How much notice do we get before home health ends?

At least 2 days before all covered services end, the agency has to give a Notice of Medicare Non-Coverage that explains how to ask for a fast appeal.¹

Can we switch agencies?

Yes. The person can leave an agency and choose another, though Medicare pays only one agency at a time.^1,6

Sources

Sources · 8 references

1. Centers for Medicare & Medicaid Services, “Medicare & Home Health Care,” Product No. 10969, July 2025. es.medicare.gov (opens in a new tab)
2. 42 CFR 424.22, “Requirements for home health services.” Legal Information Institute, Cornell Law School. law.cornell.edu (opens in a new tab)
3. 42 CFR 484.60, “Condition of participation: Care planning, coordination of services, and quality of care.” Legal Information Institute, Cornell Law School. law.cornell.edu (opens in a new tab)
4. 42 CFR 484.55, “Condition of participation: Comprehensive assessment of patients.” Legal Information Institute, Cornell Law School. law.cornell.edu (opens in a new tab)
5. CMS, “Jimmo v. Sebelius Settlement Agreement Fact Sheet.” cms.gov (opens in a new tab)
6. 42 CFR 484.50, “Condition of participation: Patient rights.” Legal Information Institute, Cornell Law School. law.cornell.edu (opens in a new tab)
7. Centers for Medicare & Medicaid Services, contact directory, “Livanta, LLC,” the Beneficiary and Family Centered Care Quality Improvement Organization for California and other western states. cms.gov (opens in a new tab)
8. 42 CFR 484.58, “Condition of participation: Discharge planning.” Legal Information Institute, Cornell Law School. law.cornell.edu (opens in a new tab)