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CMS Home and Community-Based Services (HCBS) final rule guidance

This is a CMS webpage summarizing the final Home and Community-Based Services (HCBS) regulations, related implementation resources, and transition period extensions for compliance with HCBS settings criteria.

Updated Aug 30, 2026

This page is CMI's own briefing on the topic, written by CMI. It is not the text of the regulation. Read the regulation itself in the Regulatory hub.

Home & Community Based Services Final Regulation

The final Home and Community-Based Services (HCBS) regulations set forth new requirements for several Medicaid authorities under which states may provide home and community-based long-term services and supports. The regulations enhance the quality of HCBS and provide additional protections to individuals that receive services under these Medicaid authorities.

  • Joint Statement on Implementation of the Home and Community-Based Services Settings Regulation
  • NEW: HCBS Final Rule Implementation Update
  • HCBS Technical Assistance for States
  • HCBS Training Series

Final Regulation

1915(i) State Plan HCBS, 5-Year Period for Waivers, Provider Payment Reassignment, Setting Requirements for Community First Choice, and 1915(c) HCBS Waivers - CMS-2249-F/CMS-2296-F

  • Informational Bulletin - Final regulations for HCBS provided under Medicaid's 1915(c), 1915(i) and 1915(k) authorities
  • Fact Sheets Regarding Final Regulation CMS-2249-F/CMS-2296-F
    • Overview of Regulation
    • 1915(c): Changes to HCBS Waiver Program
    • 1915(i): Key Provisions for HCBS State Plan Option
    • Summary of Key Provisions of the HCBS Settings Final Rule
  • HCBS Final Rule Webinar Presentation Download
  • Final Rule: Questions and Answers

Extension of Transition Period for Compliance with Home & Community Based Settings Criteria

A State Medicaid Director Letter was released on July 14, 2020, indicating that the transition period for compliance with home and community based settings criteria is extended until March 17, 2023.

An Informational Bulletin was released on May 9, 2017, indicating that the transition period for compliance with home and community based settings criteria is extended until March 17, 2022.

Home and Community-Based Services Final Rule Update: Final Statewide Transition Plan Submissions, Settings Criteria Not Impacted by the COVID-19 PHE, and Requests from States for Corrective Action Plans

A PowerPoint Slide Deck was released on May 24, 2022, sharing an updated strategy for implementation of the home and community-based settings regulation, developed in partnership with the Administration for Community Living (ACL), that aligns the focus of federal support and state compliance activities with the realities of the direct-service workforce crisis exacerbated by the COVID-19 public health emergency (PHE). CMS and ACL believe this strategy will ensure implementation of important regulatory criteria related to beneficiary rights in the short-term, with sustained state and provider efforts to fully implement all other settings criteria.

  • Tuesday, May 24, 2022 CMS COVID-19 Medicaid & CHIP COVID-19 All-State Call (ZIP, 9.84 MB)
  • All-State Medicaid & CHIP Presentation (PDF, 789.65 KB)

Note: The source material provided is a CMS webpage index of links and summary descriptions of the HCBS Final Rule and related guidance documents, rather than the full regulatory text itself. This entry reproduces the complete content of that page. For the actual regulatory text of CMS-2249-F/CMS-2296-F (codified in part at 42 CFR Part 441), providers should consult the linked Federal Register rule and CMS fact sheets referenced above.

General information, not legal advice. Requirements change; confirm against the official source before you act, or ask us how this applies to your organization.