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.
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