# 2025-06317: Hospice Gets Medicare Pay Bump and Report Card Changes

2025-06317, Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements, is a Federal Register proposed rule from Health and Human Services Department, Centers for Medicare & Medicaid Services published 2025-04-30, effective 2025-10-01; deemed significant under Executive Order 12866; PRIA reads it as touching household money (as of 2026-10-14).

- Canonical: https://policyrisk.com/federal-register/2025-06317
- As of: 2026-10-14
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Document number: 2025-06317
- Title: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Type: Proposed Rule
- Agencies: Health and Human Services Department; Centers for Medicare & Medicaid Services
- Citation: 90 FR 18568
- Published: 2025-04-30
- Effective: 2025-10-01
- Comments close: not stated
- Significant: yes (OIRA_API)
- Touches household money: yes
- Regulation identifier numbers: 0938-AV49
- Last updated: 2026-10-14

## In one line

Hospice Gets Medicare Pay Bump and Report Card Changes

## Summary

This proposed rule updates how much Medicare pays hospices in 2026, including changes to wage rates and payment limits. It also tweaks rules about hospice admissions and quality reporting, aiming to improve care for patients nearing the end of life. Hospices and patients will see these changes starting in FY 2026, with feedback open until June 30, 2025.

## Abstract

This proposed rule would update the hospice wage index, payment rates, and aggregate cap amount for Fiscal Year (FY) 2026. This rule also proposes changes to the admission to hospice regulations and the hospice face-to-face attestation requirements under the certification of terminal illness regulations. This proposed rule also includes a technical correction to the regulatory text and provides updates to the Hospice Quality Reporting Program requirements. Finally, this proposed rule solicits comments regarding requests for information surrounding future measure concepts for Hospice Quality Reporting Program.

## Effects PRIA read

- FY2026 hospice rates: 2.4% update and dollar rates: benefit, high. Medicare proposes a 2.4 percent hospice payment update for FY 2026. Proposed daily rates include Routine Home Care (RHC) $230.33 for days 1–60 and $181.51 for days 61+, Continuous Home Care full rate $1,665.23 ($69.38 per hour), Inpatient Respite Care $531.60, and General Inpatient Care $1,197.40.
- Penalty for not reporting HQRP data: -1.6% update: cost, medium. Hospices that do not submit required Hospice Quality Reporting Program (HQRP) data would have their FY 2026 payment update reduced by 4 percentage points, resulting in an effective update of -1.6 percent (2.4% minus 4%). Example reduced rates shown include RHC days 1–60 at $221.34 and days 61+ at $…
- Wage-index rules continue; county-level 5% cap retained: mixed, medium. CMS proposes to base the FY 2026 hospice wage index on FY 2022 hospital pre-floor, pre-reclassified data (cost reports beginning Oct 1, 2021 and before Oct 1, 2022), retain the hospice floor (15% increase up to 0.8000) and continue the permanent 5 percent cap on year-over-year decreases calculated…
- Physician IDG member may recommend hospice admission: benefit, low. The proposed rule would clarify that the physician member of the hospice interdisciplinary group (IDG) is among the types of physicians who can recommend a patient's admission to hospice and CMS proposes to add that physician role to regulatory text at 42 CFR 418.25.
- Face-to-face attestation must include signature and date: cost, low. CMS proposes to require that each face-to-face encounter attestation include the physician's or nurse practitioner's signature and date, and that the attestation, signature, and date be a separate, clearly titled section of, or addendum to, the recertification form.
- HQRP updates, HOPE instrument, and iQIES transition: cost, medium. The proposed rule provides updates to the Hospice Quality Reporting Program (HQRP), the Hospice Outcomes and Patient Evaluation (HOPE) instrument, public reporting, and the planned transition of hospice providers from the Quality Improvement and Evaluation System (QIES) to the internet-based iQIES.…
- Estimated FY2026 increase: $695 million to hospices: benefit, high. CMS estimates the overall economic impact of the proposed FY 2026 rule to be $695 million in increased payments to hospices in FY 2026.

## Related documents

- [2026-20281](https://policyrisk.com/federal-register/2026-20281): Global Benchmark for Efficient Drug Pricing (GLOBE) Model, 2026-10-02
- [2026-20131](https://policyrisk.com/federal-register/2026-20131): Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality…, 2026-10-01
- [2026-19959](https://policyrisk.com/federal-register/2026-19959): Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Prog…, 2026-09-30
- [2026-20067](https://policyrisk.com/federal-register/2026-20067): Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Correction, 2026-09-30
- [2026-19946](https://policyrisk.com/federal-register/2026-19946): Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospectiv…, 2026-09-29
- [2026-15652](https://policyrisk.com/federal-register/2026-15652): Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality…, 2026-08-03

## Sources
- [2025-06317 on federalregister.gov](https://www.federalregister.gov/documents/2025/04/30/2025-06317/medicare-program-fy-2026-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting)
- [2025-06317 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2025-04-30/pdf/2025-06317.pdf)

## Related
- [Previous: 2025-06298, Medicare Program; FY 2026 Inpatient Psychiatric Facilities Prospective Payment…](https://policyrisk.com/federal-register/2025-06298)
- [Next: 2025-06336, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System…](https://policyrisk.com/federal-register/2025-06336)
- [All Federal Register documents](https://policyrisk.com/federal-register)

Source: PRIA, https://policyrisk.com/federal-register/2025-06317 (as of 2026-10-14).