If you’re planning a Medicare-certified home health agency or hospice, one date has probably been on your mind since May: November 13, 2026. That’s when the federal freeze on new Medicare enrollment is scheduled to end. The question most owners ask is “when does the freeze lift?” The better question is “will I be ready to bill on the day it does?”
Where things stand
- On May 13, 2026, CMS imposed a six-month nationwide moratorium on new Medicare enrollment for home health agencies and hospices. It covers every state, territory and Washington, DC.
- Existing providers aren’t affected. They keep operating and billing as normal.
- The moratorium can be extended in further six-month periods, and any extension or lifting has to be published in the Federal Register.
- As of mid-October 2026, CMS hasn’t announced whether it will extend the freeze or let it end. History is a reason for caution: a similar home health moratorium in 2013 was extended repeatedly and lasted years.
We covered the freeze itself in detail when it started: what’s frozen, what isn’t, and how to plan around it.
Why “wait for the freeze to lift” is the wrong plan
Getting from zero to your first Medicare payment isn’t one step. It’s a chain, and each link takes time:
- State license. Two to six months in most states, depending on the state and how clean your application is.
- Operating history. You need real patients and real records before anyone will survey you. In Texas, for example, an agency must have served at least 10 patients, with seven active on survey day.
- Accreditation readiness. Policies, complete personnel files, a working QAPI program and clinical records that will stand up to an ACHC, CHAP or Joint Commission survey. Building that properly takes months, not weeks.
- Medicare enrollment and certification. Your CMS-855A application through your Medicare Administrative Contractor, then the certification survey.
Only the last step is blocked by the freeze. If you wait until November 13 to start the first three, you’re not first in line when enrollment reopens. You’re at the back of a new line, behind everyone who used the freeze to get ready.
Why accreditation is the critical path
State survey agencies are backed up everywhere, and some states, Texas among them, aren’t doing initial Medicare certification surveys at all. That makes a CMS-approved accreditor the practical route for most new agencies. But accreditation isn’t a form you file. It’s a survey of how your agency actually runs, and you can’t cram for it. Read more in why new agencies need accreditation.
What to do during the freeze
- Get your state license. The moratorium doesn’t touch state licensing.
- Serve private-pay clients. It brings in revenue and builds the patient history surveyors want to see. Our guide to launching private-pay care covers how.
- Build accreditation-ready systems now: policies that match your workflows, complete staff files from the first hire and a QAPI program that’s already collecting data.
- Prepare your enrollment package so it can go to your Medicare Administrative Contractor as soon as enrollment reopens.
And if CMS extends it?
Then none of that work is wasted. You’ll have a licensed agency, paying private clients, and systems that already meet the standards surveyors check. The agencies that lose out from an extension are the ones that put everything on hold waiting for it.
How we help
We build agencies accreditation-ready from day one and handle the full ACHC or CHAP submission, at one fixed price. See our accreditation support for what’s included.
Want to be ready the day enrollment reopens? Book a free discovery call and we’ll map your timeline from state license to first Medicare claim.
This article is general information, not legal advice. The moratorium’s status can change at short notice; we check the Federal Register and current CMS guidance as part of every project.
