Guiding an Improved Dementia Experience (GUIDE) adjusts monthly payments up to plus 10% or minus 3.5% from July 2026 through June 2027. Caregivers can verify locally whether a program serves their area, who qualifies, and how respite works at no charge. UCLA Health describes GUIDE as a voluntary eight-year nationwide test that started July 1, 2024 UCLA Health overview. It supports people living with dementia and their unpaid caregivers.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Official resources:
- Check eligibility on CMS’s official study page — Use this page to check the study’s participation requirements.
- Read the official guidance from CMS — Use this primary source to verify the official guidance.
Table of Contents
- What changes for GUIDE payments in 2026?
- What do families pay for GUIDE services?
- Who can enroll in GUIDE?
- How can caregivers check local options?
What changes for GUIDE payments in 2026?
Performance year 2026 runs July 2026 through June 2027. During that year, CMS applies a performance-based adjustment to the monthly Dementia Care Management Payment. According to analysis from Elli Cares, the adjustment moves that monthly payment up or down across five measures performance-year analysis from Elli Cares.
The top increase is 10%. The largest decrease is 3.5%. The change affects program revenue, not family bills. It rewards stronger measured performance and reduces payment when measured performance is weaker.
What do families pay for GUIDE services?
CMS pays participating programs a set amount per beneficiary per month instead of fee-for-service billing CMS GUIDE model page. That amount covers dementia-care management. It also includes up to 2,500 dollars per year per eligible patient for respite. Respite can include in-home help, adult-day services, and facility-based care.
CMS FAQs state that GUIDE services including respite carry no beneficiary cost-sharing CMS GUIDE FAQs. Participating programs may not charge aligned patients for them. For a caregiver, this means overnight coverage or daytime relief arranged through GUIDE should not bring a separate GUIDE bill. Ask the program how it schedules respite and who provides it.
Who can enroll in GUIDE?
The Alzheimer's Association lists three main enrollment screens. The person needs a confirmed dementia diagnosis. They need Original Medicare Parts A and B as the primary payer. Several groups are excluded.
They include people in Medicare Advantage, PACE, or hospice. They also include long-term nursing-home residents. These rules matter before travel or referral. A family member with the right diagnosis still cannot join through a GUIDE site when the payer or residence rule blocks enrollment.
How can caregivers check local options?
GUIDE is available only through participating organizations. CGS Medicare reported that CMS announced 330 participants on July 8, 2025, with a regularly updated participant list.
Callers should confirm three facts. Use this short check: CMS GUIDE FAQs point families to the CMS participant list, the CMS GUIDE site, and Medicare at 800-633-4227. Ask the local GUIDE site directly about its tier decision and respite process.
- Is there an active GUIDE site serving our ZIP code?
- Does our relative meet the diagnosis, Medicare, and residence rules?
- What eligibility tier applies, and how does this site deliver respite?
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