CMS Update · 2026

What Changed in OASIS-E2: Item-by-Item Guide

OASIS-E2 took effect April 1, 2026. CMS calls it a minor revision: one item removed, three items replaced or modified, three items added to Resumption of Care, and a long list of coding tips pulled from the OASIS Q&As. Here is each change, verified against the final CMS manual.

Key Takeaways

  • →Removed: O0350 Patient's COVID-19 Vaccination Is Up to Date.
  • →Replaced: A1250 Transportation became A1255 (SOC/ROC only). M0069 Gender became A0810 Sex.
  • →Added to ROC: A1110 Language, B0200 Hearing, and B1000 Vision.
  • →Revised: J1900 Number of Falls injury descriptions, plus a new fall definition in J1800 and M1033.
  • →Unchanged: the PDGM functional items (M1800-M1860, M1033), the Section GG scale, and the diagnosis items.

⚠️ Authoritative source

Every change below comes from Section 1.4 and Appendix D of the final OASIS-E2 Guidance Manual and from the CY 2026 Home Health PPS final rule. Appendix D lists every guidance edit. Use it as the binding source.

The Big Picture: What Stayed the Same

OASIS-E2 keeps the architecture of OASIS-E and OASIS-E1:

  • The assessment time points: SOC, ROC, Follow-up, Transfer, Discharge, and Death at Home
  • The M-item and standardized item sections, A through Q
  • Section GG self-care and mobility activities and the 6-point scale
  • The PDGM functional items, M1800-M1860 and M1033, with unchanged response options
  • M1021 and M1023 diagnosis coding and symptom control ratings

Agencies with sound OASIS-E1 workflows need targeted updates, not a rebuild. For any assessment dated before April 1, 2026, keep using OASIS-E1 guidance.

1. Item Removed: O0350 COVID-19 Vaccination

CMS removed O0350 Patient's COVID-19 Vaccination Is Up to Date. The item was added in OASIS-E1 to support a quality measure, and CMS dropped the item when it removed the measure in the CY 2026 final rule. Delete the field from EMR forms and QA rules for assessments dated on or after April 1, 2026.

2. Items Replaced: A1255 Transportation and A0810 Sex

A1250 Transportation becomes A1255 Transportation

  • New question: in the past 12 months, has a lack of reliable transportation kept the patient from medical appointments, meetings, work, or getting things needed for daily living?
  • New codes: 0 Yes, 1 No, 7 Patient declines to respond, 8 Patient unable to respond.
  • New time points: SOC and ROC only. CMS removed Discharge.
  • New source rules: if the patient declines, code 7 and do not use a proxy or records. Use records only when the patient cannot respond and no proxy answers.

CMS made the change to align with a similar item used in other CMS programs.

M0069 Gender becomes A0810 Sex

A0810 Sex replaces M0069 Gender at Start of Care. The manual notes no change in the data element.

3. Items Added to Resumption of Care

Three items now appear at ROC as well as SOC: A1110 Language, B0200 Hearing, and B1000 Vision. Update ROC templates and train clinicians to complete them on every resumption.

4. Falls: J1900 Descriptions and a New Fall Definition

  • J1900 injury examples now read "includes but is not limited to." Major injury now lists traumatic fractures, dislocations and subluxations, internal organ injuries, amputations, spinal cord injuries, head injuries, and crush injuries.
  • Pathological fractures confirmed as pathological, not traumatic, are not a major injury from a fall.
  • External force: in J1800 and M1033, a fall caused by an overwhelming external force now counts as a fall. OASIS-E1 excluded it.
  • Balance training: an anticipated loss of balance during supervised balance training is not a fall, unless a fall or intercepted fall causes a major injury. Then it counts.

M1033 is a PDGM functional item, so the fall definition change can move functional points. Retrain clinicians before they code M1033 response 1.

5. Guidance Pulled From the OASIS Q&As

CMS folded Q&A guidance into the manual. Changes worth training on:

  • Section GG: the assessor's presence is not automatically supervision. A ramp or elevator does not stand in for steps in GG0170M, N, or O. GG0100 and GG0110 prior-function tips were expanded.
  • M1840: incontinence on the way to the toilet counts only if it affects the ability to get there and transfer safely.
  • M1311 and M1340: a pressure ulcer treated surgically with a graft is a surgical wound until healed.
  • Pain and mood: J0510-J0530 pain interview instructions and D0150/D0160 PHQ instructions were revised.
  • Administrative items: new tips for M0030, M0032, M0090, M0100, M0150, M1000, M1018, and M2420.

Chapter 1 also gained a section on all-payer OASIS. Since July 1, 2025, agencies collect and submit OASIS for skilled patients with any pay source who start care on or after that date, unless exempt.

6. What Did Not Change: SDOH and PDGM

SDOH: the CY 2025 rule planned four new items: Living Situation (R0310), two Food items (R0320A and R0320B), and Utilities (R0330). The CY 2026 final rule removed them before collection started, citing burden. OASIS-E2 has no housing, food, or utilities items. Transportation is the only SDOH item CMS replaced.

PDGM: the case-mix model is unchanged by E2. The functional impairment level still comes from M1800-M1860 and M1033, not Section GG. CMS recalibrated points, thresholds, and case-mix weights for CY 2026 through rulemaking, separate from the OASIS version change.

What QA Teams Need to Update

  • Remove O0350 from forms and edit checks
  • Swap A1250 for A1255 and drop it from Discharge
  • Swap M0069 for A0810
  • Add A1110, B0200, and B1000 to ROC templates
  • Update fall rules for J1800, J1900, and M1033
  • Remove any leftover GG discharge goal fields from OASIS-E templates
  • Refresh training on the new Q&A coding tips

Lime's OASIS Review flags OASIS-E2 inconsistencies so your QA team corrects them before submission.

Item-by-Item Guides

Related OASIS-E2 Resources

OASIS-E2 Changes, FAQ

What changed in OASIS-E2?
OASIS-E2, effective April 1, 2026, is a minor revision. CMS removed O0350 COVID-19 vaccination status, replaced A1250 Transportation with A1255 Transportation (now SOC/ROC only), replaced M0069 Gender with A0810 Sex, added A1110 Language, B0200 Hearing, and B1000 Vision to the Resumption of Care time point, and revised the J1900 fall injury descriptions. The manual also folds in guidance from the quarterly OASIS Q&As and adds a section on all-payer OASIS collection.
Are M-items different in OASIS-E2?
Most M-items are unchanged. M0069 Gender became A0810 Sex with no change in the data element. Several M-items gained coding tips from the OASIS Q&As, including M1840 Toilet Transferring, M1311 pressure ulcers, M1033 Risk for Hospitalization, M0090, and M0100. The PDGM functional items, M1800-M1860 and M1033, keep their response options.
How are GG-items affected in OASIS-E2?
GG0130 and GG0170 keep the same activities and 6-point scale. E2 adds guidance from the Q&As: a clinician's presence to complete the assessment is not automatically supervision, and a ramp or elevator does not substitute for steps in GG0170M, N, and O. The GG discharge goal was removed earlier, with OASIS-E1 on January 1, 2025. GG items do not set the PDGM functional level.
Did social determinants of health items change?
One did. A1250 Transportation was replaced by A1255, which asks about the past 12 months, uses Yes, No, declines, and unable-to-respond codes, and is collected at SOC and ROC only. CMS had planned Living Situation, Food, and Utilities items, but the CY 2026 Home Health final rule removed them before collection began. They are not in OASIS-E2.
Do OASIS-E1 workflows still work for OASIS-E2?
Mostly. Update EMR forms and QA rules for A1255, A0810, the ROC additions, the removal of O0350, and the J1900 descriptions. Then retrain staff on the new coding tips, especially the fall definition change in J1800 and M1033. Assessments dated before April 1, 2026 stay on OASIS-E1 guidance.

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