OASIS-E2 took effect on April 1, 2026. It replaces the transportation item A1250 with a revised A1255, adds hearing, vision and language items to the Resumption of Care time point, replaces M0069 Gender with A0810 Sex, removes the COVID-19 vaccination item O0350, revises J1900 response options, and updates skip patterns.
Key takeaways
- OASIS-E2 has applied since April 1, 2026, not January 1 as in a normal update cycle.
- A1255 Transportation replaces A1250 and is collected at SOC and ROC; A1250 is also removed from the discharge time point.
- B0200 Hearing, B1000 Vision and A1110 Language are now collected at Resumption of Care as well as Start of Care.
- O0350 (COVID-19 vaccination) is gone, and J1900 injury response options were revised at transfer, death at home and discharge.
CMS broke with its usual January 1 cycle and made OASIS-E2 effective on April 1, 2026. If your clinicians and coders are still working from OASIS-E1 habits, this guide lists every change in CMS's own change table and turns it into a review checklist.
Every change in CMS's change table
| Item | Time points | Change in OASIS-E2 |
|---|---|---|
| A1255 Transportation | SOC, ROC | New item, replacing A1250 (one data element added) |
| A1250 Transportation | SOC, ROC, DC | Removed; modified and moved under A1255 |
| B0200 Hearing | ROC | Added to the Resumption of Care time point |
| B1000 Vision | ROC | Added to the Resumption of Care time point |
| A1110 Language | ROC | Added to the Resumption of Care time point |
| M0069 Gender / A0810 Sex | SOC | M0069 removed; A0810 Sex replaces it (no change in number of data elements) |
| O0350 COVID-19 vaccination up to date | TRN, DAH, DC | Removed |
| J1900 Falls with injury | TRN, DAH, DC | Responses B (injury, except major) and C (major injury) revised to follow the OASIS manual |
| M0102 and M1000 | SOC/ROC, ROC | Skip instructions updated (to A1255 and to B0200 respectively) |
Source: CMS, Home Health Change Table for OASIS-E2 (effective 4/1/2026). Abbreviations: SOC start of care, ROC resumption of care, TRN transfer to an inpatient facility, DAH death at home, DC discharge.
What the changes mean in practice
Transportation moves, and the answers change
The old A1250 let clinicians check several boxes. The new A1255 is a single question about whether a lack of reliable transportation has kept the patient from medical appointments, meetings, work or getting things needed for daily living, with response options for yes, no, patient declines and patient unable to respond. Make sure your EMR templates and your clinicians' mental model match the new wording, and remember that A1250 no longer appears at discharge.
Resumption of Care now collects more up front
Hearing, vision and preferred language are used to risk-adjust quality measures and have to be available at the start of the quality episode. They were already collected at SOC. They are now required at ROC too, which means a patient who returns after an inpatient stay needs these items completed again. The skip logic also changed: M1000 now sends a patient who was not discharged from an inpatient facility to B0200, and M0102 now skips to A1255.
Sex replaces gender, and a vaccination item disappears
A0810 Sex replaces M0069 at SOC with the same male or female options. O0350 is removed at transfer, death at home and discharge, so templates that still prompt for it should be cleaned up.
Watch the training while you plan
This five-part series from an independent education provider covers OASIS-E2 for new and experienced clinicians. It is not CMS material, so always check against the manual.
Documentation pitfalls we keep seeing
- Carried-forward answers. Copying a prior assessment into a new one is the fastest way to create a gap between OASIS and the visit notes, especially for items that changed in E2.
- Answering from habit. Clinicians who learned E1 may answer the old way. A short, specific refresher on the changed items works better than a general training session.
- Disagreement between disciplines. Nursing and therapy evaluations that describe different functional levels will draw questions from a reviewer. Reconcile them before submission.
- Late corrections. Fixing an OASIS after the claim is billed is harder than catching it before. Build the review into the billing hold.
A review checklist for coders and clinicians
- Confirm the EMR assessment version in use for every SOC, ROC, transfer and discharge dated on or after April 1, 2026.
- Spot-check ROC assessments for completed hearing, vision and language items.
- Check A1255 answers against the visit notes and the patient's own statements.
- Look for stale templates still asking for O0350 or A1250 at discharge.
- Verify J1900 responses against fall documentation at transfer, death at home and discharge.
- Reconcile OASIS with the narrative. Functional scores, diagnoses and visit notes must tell the same story, because that is where reviewers and auditors look first.
This is the work our OASIS review team does item by item, and our quality assurance review adds an independent second look before claims are released.
Do not forget the October 1 coding update
The FY 2027 ICD-10-CM code set took effect on October 1, 2026. Not every new code has a PDGM clinical group or comorbidity assignment, so check that your encoder and Home Health PPS Grouper are on the FY 2027 versions, and replace deleted codes based on the documentation rather than simply dropping them. CMS keeps the current files and guidelines on its ICD-10 page. Our home health coders are working from the FY 2027 guidelines for every chart.
Want a second pair of eyes on your charts? Book a free consultation or request a demo and our team will walk through your workflow with you.
This article summarizes CMS publications as of October 2026 and is not legal advice. Always confirm details against the OASIS-E2 manual.
Frequently asked questions
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Four Pillars Coding & OASIS Desk
Our coding and OASIS desk writes about ICD-10-CM, PDGM grouping and OASIS accuracy. The team includes coders and reviewers with credentials such as BCHH-C, CPC, OASIS COQ-S, COS-C and HCS-O.