# 2026-15686: Hospice Gets Pay Bump: Uncle Sam Tweaks Deathbed Dollars

2026-15686, Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements, is a Federal Register rule from Health and Human Services Department, Centers for Medicare & Medicaid Services published 2026-08-03, effective 2026-10-01; deemed significant under Executive Order 12866; PRIA reads it as touching household money (as of 2026-11-04).

- Canonical: https://policyrisk.com/federal-register/2026-15686
- As of: 2026-11-04
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Document number: 2026-15686
- Title: Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Type: Rule
- Agencies: Health and Human Services Department; Centers for Medicare & Medicaid Services
- Citation: 91 FR 49118
- Published: 2026-08-03
- Effective: 2026-10-01
- Comments close: not stated
- Significant: yes (OIRA_API)
- Touches household money: yes
- Regulation identifier numbers: 0938-AV78
- Last updated: 2026-11-04

## In one line

Hospice Gets Pay Bump: Uncle Sam Tweaks Deathbed Dollars

## 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.

## Effects PRIA read

- FY2027 Hospice Payments Rise: benefit, high. 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).
- Mandatory Hospice Election Addendum: benefit, low. 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): benefit, low. 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: benefit, low. 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: cost, low. 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).
- Hospice Wage Index Floor and 5% Cap Retained: benefit, medium. 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,…
- Care Compare Icon and HQRP Reporting: benefit, low. 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.

## Related documents

- [2026-22381](https://policyrisk.com/federal-register/2026-22381): Medicare and Medicaid Programs; Organ Procurement Organizations Conditions for Coverage: Revisions to the Conditions for Coverage, 2026-11-03
- [2026-22194](https://policyrisk.com/federal-register/2026-22194): Medicare Program; CY 2027 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System, Acute Kidney Injury (AKI) Dialysis Paym…, 2026-10-30
- [2026-21420](https://policyrisk.com/federal-register/2026-21420): Medicare Program; Implementation of Sections 6219, 6220, and 6224 of the Consolidated Appropriations Act, 2026, 2026-10-20
- [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

## Sources
- [2026-15686 on federalregister.gov](https://www.federalregister.gov/documents/2026/08/03/2026-15686/medicare-program-fy-2027-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting)
- [2026-15686 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2026-08-03/pdf/2026-15686.pdf)

## Related
- [Previous: 2026-15681, Reducing Bureaucracy and Burden in Family Violence and Prevention Services](https://policyrisk.com/federal-register/2026-15681)
- [Next: 2026-15720, Rescinding Portions of Department of the Treasury Title VI Regulations To Confo…](https://policyrisk.com/federal-register/2026-15720)
- [All Federal Register documents](https://policyrisk.com/federal-register)

Source: PRIA, https://policyrisk.com/federal-register/2026-15686 (as of 2026-11-04).