What Is OASIS-E2? The Complete 2026 Guide for Home Health Agencies

What Is OASIS-E2?

OASIS-E2 is the latest version of the Outcome and Assessment Information Set (OASIS), published by the Centers for Medicare & Medicaid Services (CMS) for Medicare-certified home health agencies. It builds on OASIS-E (effective January 1, 2023) and OASIS-E1 (effective January 1, 2025), with a small set of item changes and added guidance from the CMS OASIS Q&As.

OASIS-E2 is used at the same five required time points as previous versions: Start of Care (SOC), Resumption of Care (ROC), Recertification, Transfer to Inpatient Facility, and Discharge. The data continues to drive three core CMS programs: PDGM payment classification, the Home Health Quality Reporting Program (HH QRP), and Home Health Star Ratings.

When Does OASIS-E2 Take Effect?

OASIS-E2 took effect April 1, 2026. All assessments with a Start of Care, Resumption of Care, Recertification, Transfer, or Discharge date on or after April 1, 2026 must use the OASIS-E2 item set, submitted under the OASIS-E2 data specifications in iQIES. Most home health EMR vendors (HCHB, WellSky, MatrixCare, Axxess) pushed OASIS-E2 form updates automatically, but agencies are responsible for ensuring clinicians and QA staff are trained on the new items.

CMS publishes the OASIS-E2 Guidance Manual as a free PDF, along with the item sets and the submission specifications. For every download link, the rules on which edition applies to a given assessment date, and the item references, see our OASIS-E2 manual guide. For working references, see the item-by-item summary of what changed and the clinician quick-reference checklist.

What's New in OASIS-E2 vs. OASIS-E1?

OASIS-E2 is a minor revision, not a rewrite. The M-items, Section GG functional items, time points, and PDGM functional items stay the same. Appendix D of the CMS manual lists every change.

For the full item-level change list, see What Changed in OASIS-E2: Complete Item-by-Item Comparison. For a side-by-side view, see OASIS-E1 vs. OASIS-E2 Comparison.

The verified changes:

• Removed: O0350 Patient's COVID-19 Vaccination Is Up to Date.
• Replaced: A1250 Transportation became A1255 Transportation, collected at SOC and ROC only. M0069 Gender became A0810 Sex.
• Added to Resumption of Care: A1110 Language, B0200 Hearing, and B1000 Vision.
• Revised: J1900 fall injury descriptions, plus a new fall definition used in J1800 and M1033.
• New guidance: coding tips from the OASIS Q&As for Section GG, M1840, M1311, pain, PHQ, and administrative items.

E2 adds no housing, food, or utilities items. CMS finalized Living Situation, Food, and Utilities items in the CY 2025 rule, then removed them in the CY 2026 rule before collection began.

Always reference the official CMS OASIS-E2 Guidance Manual for authoritative item-level guidance.

Who Must Use OASIS-E2?

OASIS-E2 is required for all Medicare-certified home health agencies submitting OASIS data for adult (non-maternity) skilled-care patients. This includes assessments completed by:

• Registered Nurses (RNs)
• Physical Therapists (PTs)
• Occupational Therapists (OTs)
• Speech-Language Pathologists (SLPs)

Agencies that fail to submit OASIS-E2 data on time, or that submit incomplete or inaccurate data, face Home Health Quality Reporting Program (HH QRP) penalties (including a 2 percentage-point reduction to the annual market basket update) and increased audit risk.

How OASIS-E2 Affects PDGM Payment

Under the Patient-Driven Groupings Model (PDGM), Medicare combines claim data with OASIS data to classify each 30-day period. The case-mix variables include:

• One of 12 clinical groups (set by the principal diagnosis on the home health claim)
• A functional impairment level (Low / Medium / High, set by points from M1800-M1860 and M1033)
• A comorbidity adjustment (None / Low / High, set by secondary diagnoses on the claim)

Inaccurate OASIS-E2 responses can result in underpayment (lost revenue) or overpayment (compliance risk, ADRs, and potential recoupment). Functional impairment scoring is one of the most common sources of OASIS scoring errors, and one of the most impactful for payment.

This makes OASIS-E2 accuracy as critical for revenue as it is for compliance. Pair clinician training with automated OASIS QA review, which flags inconsistencies so your QA team corrects them before submission. Item-level guidance lives in our M1800-M1860 guide.

How AI Scribes Handle OASIS-E2

Manual OASIS-E2 documentation can take a clinician 30–45 minutes per assessment, and that's before any QA review. AI ambient scribes purpose-built for OASIS-E2 change this dramatically:

• The clinician opens the app, hits record, and conducts the visit naturally.
• The AI listens to the clinical conversation and drafts OASIS-E2 responses (M-items, GG-items, and other standardized items). The clinician confirms every final response.
• Real-time QA flags inconsistencies, missing items, and PDGM-impacting scoring before submission.
• Approved data syncs directly to the EMR (HCHB, WellSky, MatrixCare, Axxess, DSL).

Lime's OASIS Scribe reports a 75% reduction in documentation time and 95% accuracy.

How to Get Your Agency Ready for OASIS-E2

A typical OASIS-E2 rollout involves four streams of work:

1. Clinician training: See the OASIS-E2 Training Guide for a 90-day curriculum.
2. QA workflow updates: See the OASIS-E2 Compliance Guide.
3. Implementation playbook: See the OASIS-E2 Implementation Plan.
4. Quick-reference for clinicians: See the OASIS-E2 Checklist.