TMMedicare Contractors Will Post Targeted Probe and Educate Results Starting Nov. 2
Starting November 2, every Medicare Administrative Contractor (MAC) will have to post its Targeted Probe and Educate results on its website each quarter. CMS made the change in Change Request 14616 (Transmittal 13971, dated September 30), which updates the Medicare Program Integrity Manual. At a minimum, each MAC must list the most common reasons for denial, up to three, for every problem area it is probing, and it is encouraged to share more when that would help providers. For home health and hospice agencies, it is the first time these findings will be published the same way across every contractor.
Why Targeted Probe and Educate results matter for home health
TPE has run nationally since 2017. A MAC selects providers with higher error rates or unusual billing patterns, reviews a sample of their claims, and offers up to three rounds of review and education before persistent problems are referred for further action such as prepayment review or extrapolation. Until now, the specific reasons claims were denied mostly stayed between the MAC and the agency under review. Some contractors already posted top denial reasons, but CMS framed this instruction as a push for consistency, and LeadingAge called it a big win for providers.
The practical value is that every agency can learn from reviews it was never part of. Once your Home Health and Hospice MAC posts its first quarterly list, treat it as a free self-audit checklist. Pull a handful of your own recent charts for each posted reason and check them against it, compare the list with your own additional documentation request history, and share the findings with intake, clinical managers, and billing so the fix happens before claims go out rather than after a denial letter arrives. Worth noting: the requirement covers denial reasons, not error rates or counts, so the postings will tell you what is going wrong more than how often.
Many of the denial reasons that show up in medical review trace back to the visit record itself: whether the planned visit actually happened, whether it was documented completely, and whether the paperwork lines up with what was ordered. That is where CareSync® fits for agencies that want one clear view of planned versus completed visits, so gaps are visible while there is still time to correct them.
One more thing on our side. Changes like this land faster when people in the field can compare notes, so we are quietly building an invite-only circle for home health professionals. We will share more when it is ready, and we hope it turns into something genuinely useful for the field. In the meantime, bookmark your MAC's medical review page and plan to check it after November 2.
Sources: CMS Transmittal 13971 / Change Request 14616 (September 30, 2026); HomeCare, "CMS Says MACs Must Publish Quarterly TPE Results" (October 7, 2026); McKnight's Home Care, "CMS contractors' aggressive enforcement raises alarm for home care advocates" (October 2026).