The six service lines CMS records
Every Medicare-certified home health agency reports which of six service lines it offers. This is the complete list — an agency cannot report a seventh, and anything else it may sell privately sits outside the Medicare home health benefit.
Skilled nursing is care that requires a licensed nurse: wound care, injections, IV therapy, catheter care, medication management, and monitoring an unstable condition. It is the most commonly offered service line.
Physical therapy restores strength, balance, mobility, and gait — the service most often central to recovery after a joint replacement, a fall, or a stroke.
Occupational therapy is about regaining the ability to carry out daily activities: dressing, bathing, cooking, and adapting either the home or the task so they become possible again.
Speech-language pathology covers speech, language, cognition, and swallowing. It is frequently needed after a stroke and in progressive neurological conditions.
A home health aide provides hands-on personal care such as bathing, dressing, and mobility assistance, delivered alongside a skilled service rather than as a standalone benefit.
Medical social services provide counselling and help with the social and financial pressures around an illness, including connecting a household to community resources. This is the least commonly offered line.
How common each service actually is
Availability is not uniform, and the gap between the most and least common service is wide enough to change which agencies can serve a given care plan. Our national analysis of every Medicare-certified agency measures the share offering each line, and the spread runs from roughly 83% down to roughly 66%.
That matters more than it first appears. A discharge plan calling for speech-language pathology narrows the field considerably compared with one calling for skilled nursing, and in some states the narrowing is far sharper than the national figure suggests.
Because these shares change with each CMS data release, we publish them as live analysis rather than fixing them in prose here. The service-availability research carries the current numbers, including the state-by-state spread.
What Medicare actually covers
Medicare's home health benefit carries eligibility conditions that surprise many families. You generally must be homebound, meaning leaving home requires a considerable and taxing effort, and you must need intermittent skilled care: skilled nursing, physical therapy, or speech-language pathology.
The consequence is that a home health aide is covered only alongside a qualifying skilled service. Medicare home health does not pay for ongoing personal care, homemaker services, or 24-hour care on their own. Families looking for that are usually looking at private-duty home care, which is a different service, paid for differently, and not covered by the CMS ratings on this site.
A doctor must certify the need, and the agency must be Medicare-certified. Every agency in our directory is Medicare-certified — that is what places it in the CMS dataset at all.
Check services before you compare ratings
Service availability is a hard constraint; a star rating is a summary of past performance. Applying them in the wrong order wastes time, because there is no value in shortlisting the highest-rated agency in a county if it does not offer the therapy the discharge plan requires.
Work in this order. Filter by the services actually needed. Compare CMS quality-of-patient-care stars among the agencies that remain. Then check how much CMS data each of those agencies reports — a missing star is not a low star, and usually means CMS lacked enough episodes to measure reliably.
Every agency page on this site lists the service lines that agency reports to CMS alongside its rating and reported measures, so both checks happen in one place.
Questions worth asking the agency
The CMS record tells you what an agency reports. It does not tell you how that agency operates day to day, so a short call is worth making.
Ask how quickly they can start after discharge, and whether that timing holds for the specific service you need. Ask how visits are scheduled and what happens on evenings and weekends. Ask who your point of contact is when something changes, and how they coordinate with the physician who certified the care.
Ask directly whether they currently have capacity for that service in your area. Reporting a service line to CMS is not the same as having a therapist available this week.