Hospice Gets Pay Bump: Uncle Sam Tweaks Deathbed Dollars
Published Date: 8/3/2026
Rule
Summary
This final rule updates the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2027. This final rule also includes an analysis of Medicare non-hospice spending, including details regarding a hospice service and spending variation index, and finalizes the requirement that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election. Additionally, this rule finalizes conforming changes to discharge from hospice care regulations and changes to the face-to-face encounter regulations. This final rule also includes a summary of comments received on our requests for information regarding community- based palliative care; the construction of a hospice specific wage index; and the overlap between hospice and medical aid in dying laws. Finally, this rule finalizes changes to the Hospice Quality Reporting Program.
Analyzed Economic Effects
7 provisions identified: 6 benefits, 1 costs, 0 mixed.
FY2027 Hospice Payments Rise
Medicare will increase payments to hospices by an estimated $755 million in Fiscal Year 2027 (FY 2027 runs October 1, 2026 through September 30, 2027).
Hospice Wage Index Floor and 5% Cap Retained
CMS finalized that the hospice floor and the permanent 5 percent cap on any decrease to a geographic area's wage index remain in place for FY 2027. The hospice floor adjusts pre-floor, pre-reclassified hospital wage index values below 0.8000 by a 15 percent increase subject to a maximum of 0.8000, and the 5 percent cap is calculated at the county level with transition '50XXX' codes where applicable. The FY 2027 hospice wage index is based on hospital cost report data for periods beginning October 1, 2022 through September 30, 2023.
Mandatory Hospice Election Addendum
Hospices must provide the hospice election statement addendum to all Medicare beneficiaries at the time the beneficiary elects hospice care. This requirement is finalized in the FY 2027 rule.
New Hospice Spending Variation Index (SSVI)
CMS finalized a hospice Service and Spending Variation Index (SSVI) that uses a scoring system monitoring nine claims-based metrics to rank providers and help beneficiaries make more informed decisions and support program integrity.
Telehealth Face-to-Face Extended to 2027
CMS extended the telehealth allowance for the face-to-face encounter used solely for hospice recertification through December 31, 2027, and finalized a new requirement that such encounters include modifiers or codes identifying them.
Limits on Telehealth in Oversight Cases
The rule finalizes a prohibition on using telehealth to conduct the face-to-face encounter in specific situations related to moratoriums (section 1866(j)(7) of the Act), enhanced oversight (section 1866(j)(3) of the Act), or enrollment status (section 1866(j) of the Act).
Care Compare Icon and HQRP Reporting
The rule finalizes changes to the Hospice Quality Reporting Program to add a data submission icon to the Medicare.gov Care Compare tool and includes public reporting timeframes and future measures for the HQRP.
Personalized for You
How does this regulation affect your finances?
Personalize government policy and PRIA will tell you what this federal register document means for your household, plus every other regulation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Key Dates
Department and Agencies
Related Federal Register Documents
2026-15652, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2027 and Updates to the IRF Quality Reporting Program
This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2027. As required by statute, this final rule includes the classification and weighting factors for the IRF prospective payment system's (PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2027. It also finalizes the third and final of the 3-year phaseout of the rural adjustment, which began in FY 2025. This final rule includes a solicitation for public comments on alternative data sources for the IRF PPS wage index; requires all therapy treatments and/or therapy evaluations to begin no later than 36 hours from midnight on the day of admission; finalizes requirements for the initial Interdisciplinary Team meeting to occur on or before 4 days from the date the patient is admitted; and summarizes a request for information on potential future IRF PPS payment reform. Additionally, this final rule includes updates to the IRF Quality Reporting Program and changes to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.
2026-15562, Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2027
Starting October 1, 2026, skilled nursing facilities (SNFs) will see updated payment rates and new rules for how Medicare pays them. The Quality Reporting and Value-Based Purchasing programs are also getting tweaks to help improve care. These changes affect SNFs nationwide and could impact how much money they get and how they report quality data.
2026-14897, Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes
Starting October 1, 2026, new rules will change how states handle health care-related taxes under Medicaid. These changes set clear limits on tax amounts based on 2025 levels and will gradually lower those limits in some states by 2027. States and taxpayers should get ready for tighter rules and better oversight that could affect tax collections and Medicaid funding.
2026-14709, Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction
This correction fixes some typos and technical mistakes in the 2027 health insurance rules under the Affordable Care Act. It mainly affects people and organizations involved in health coverage plans by clarifying when the rules take effect and restoring some important regulation details. These fixes take effect on July 20, 2026, ensuring smoother and clearer health plan operations next year.
2026-14327, Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
Starting in 2027, Medicare and Medicaid are updating how doctors and clinics get paid to better match today’s medical care and laws. This includes new rules for drug price rebates, shared savings programs, and payments for rural and specialty care. These changes affect doctors, patients, and drug makers, aiming to save money and improve care quality.
2026-13656, Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots
Starting in 2027, Medicare is updating how it pays hospitals and surgery centers for outpatient care, aiming to make payments fairer and clearer. They’re also improving quality reporting and asking for ideas to make hospital price info easier to understand and compare. These changes affect hospitals, surgery centers, and patients, with some new rules and opportunities coming soon.
Previous / Next Documents
Previous: 2026-15681, Reducing Bureaucracy and Burden in Family Violence and Prevention Services
This final rule removes duplicative and unnecessary sections from the Family Violence Prevention and Services Program regulations. These amendments will streamline the Family Violence Prevention and Services regulations and make them more accessible to the public.
Next: 2026-15720, Rescinding Portions of Department of the Treasury Title VI Regulations To Conform More Closely With the Statutory Text and To Implement an Executive Order
By this rule, the Department of the Treasury ("Department") amends its regulations implementing Title VI of the Civil Rights Act of 1964 ("Title VI") to eliminate disparate-impact liability. These amendments align the Department's regulations with Title VI's original public meaning, avoid constitutional concerns, reduce compliance costs, and serve the public interest. In addition, these revisions implement changes directed in the Executive order, Restoring Equality of Opportunity and Meritocracy.