The OASIS-E2 Manual: Where to Get It and How to Use It
The official guidance manual is free from CMS. Here is where to download it, what changed for April 1, 2026, and the working references your clinicians will use daily.
The Short Answer
The OASIS-E2 Guidance Manual is a free PDF from CMS, effective April 1, 2026. Download it from the CMS OASIS User Manuals page. It is the authoritative source for item-by-item guidance, definitions, time points, and response-specific instructions for every OASIS-E2 item. The item sets live on the CMS OASIS Data Sets page, and the data submission specifications have their own CMS page.
The Official CMS Downloads
Three documents cover the full OASIS-E2 picture. All three are free:
- Final OASIS-E2 Guidance Manual (direct PDF). The document itself, effective April 1, 2026. CMS file links move when documents revise, so bookmark the hub page below.
- CMS OASIS User Manuals page. The Downloads section of the CMS OASIS User Manuals page holds the final manual and the OASIS-E2 Q&A documents.
- OASIS-E2 item sets. The all-items version and every time-point version of the instrument, on the CMS OASIS Data Sets page.
- OASIS-E2 data submission specifications. For your EMR vendor and IT team, covering iQIES submission requirements.
What's Inside the Guidance Manual
The manual is the reference QA teams and educators work from. It covers item-by-item guidance with definitions and time points, response-specific instructions for each OASIS-E2 item, coding conventions, and the conventions for skip patterns and dashes. The Q&A documents answer the edge cases the manual text leaves open. When an auditor or a MAC questions a response, the manual language in force on the assessment date is the standard.
Which Version Applies to Your Assessment
The assessment date decides the manual:
- On or after April 1, 2026: OASIS-E2 manual.
- January 1, 2025 through March 31, 2026: OASIS-E1 guidance.
- January 1, 2023 through December 31, 2024: OASIS-E guidance.
Looking for the OASIS-E or OASIS-E1 manual? CMS keeps superseded editions in the Downloads section of the same OASIS User Manuals page, below the current edition. Direct PDF links change when CMS revises a document, so work from that page rather than a saved link.
Keep prior manuals available through your lookback and audit window. ADRs reference the guidance in force when the clinician completed the assessment, not the current edition. For the version history in one view, see our OASIS overview and the E1 vs E2 comparison.
From Manual to Practice
The manual tells you what CMS requires. Your clinicians need it in working form:
- What changed in OASIS-E2, an item-by-item summary of the E1-to-E2 differences
- The clinician quick-reference checklist for field use
- A 90-day training curriculum for RNs, PTs, OTs, and SLPs
- The complete OASIS-E2 guide covering PDGM impact and compliance
Agencies using OASIS Scribe get the guidance applied in the workflow: the AI drafts manual-aligned responses from the visit conversation and flags inconsistencies, missing data points, and common errors so your QA team corrects them before submission. The assessing clinician confirms every final response, as the manual requires. For item-level summaries, see the OASIS-E2 Item Guide.
Free download
The printable OASIS-E2 checklist
One page for the clinician, one for the QA reviewer. Print it or keep it on your phone.
- ✓Before, during and after the visit, in visit order
- ✓Section GG, BIMS, PHQ and SDOH checks
- ✓Pre-submission consistency checks
- ✓A separate QA reviewer checklist
FAQ
OASIS-E2 Manual, Answered
The questions agencies ask about the CMS guidance manual.
CMS publishes the final OASIS-E2 Guidance Manual as a free PDF in the Downloads section of its OASIS User Manuals page at cms.gov/medicare/quality/home-health/oasis-user-manuals. The OASIS-E2 Q&A documents live on the same page. No login or purchase is required.
Yes. CMS publishes the guidance manual, the item sets, and the data submission specifications at no cost. Paid third-party editions add commentary, tabs, and training material. The required content is free from CMS.
April 1, 2026. Assessments with a Start of Care, Resumption of Care, Recertification, Transfer, or Discharge date on or after April 1, 2026 follow OASIS-E2 guidance. CMS posted the final manual and data specifications in March 2026.
The item set is the instrument itself: the all-items form and the time-point versions, posted on the CMS OASIS Data Sets page. The guidance manual explains how to complete each item: definitions, time points, response-specific instructions, and coding conventions. Clinicians chart from the item set. QA teams and educators work from the manual.
The assessment date decides. Assessments dated on or after April 1, 2026 follow the OASIS-E2 manual. Assessments dated January 1, 2025 through March 31, 2026 follow OASIS-E1 guidance. Keep both manuals during any lookback period, since audits reference the guidance in force on the assessment date.
Superseded editions stay on the same CMS OASIS User Manuals page as the current one, in the Downloads section below the active manual. OASIS-E guidance covers assessments dated January 1, 2023 through December 31, 2024, and OASIS-E1 covers January 1, 2025 through March 31, 2026. Keep the edition in force on the assessment date, because that is the guidance an ADR or audit will be measured against, not the current one.
Lime's ambient scribe drafts OASIS-E2 responses aligned to current CMS guidance, and the clinician confirms every final response. Real-time coaching flags missed OASIS sections, weak narratives, and documentation gaps while the clinician is still with the patient. For agencies wanting the reference material in working form, our item-by-item change summary and clinician checklist condense the manual into field-ready tools.
Want OASIS-E2 guidance applied automatically?
See OASIS Scribe