Proposed FY26 Hospice Wage Index and Payment Rate

Proposed FY26 Hospice Wage Index and Payment Rate
CMS press release; 4/11/25
On April 11, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that proposes updates to Medicare payment policies and rates for hospices under the Fiscal Year (FY) 2026 Hospice Wage Index and Payment Rate Updated Proposed Rule (CMS-1835-P). [Major provisions include:]

1. For FY 2026, CMS proposes to update the hospice payment rate by 2.4% (an estimated increase of $695 million in payments from FY 2025).
2. Hospice payments are subject to a statutory aggregate cap which limits the overall payments made to a hospice annually. The proposed hospice cap amount for FY 2026 is $35,292.51.
3. This rule also proposes to clarify in the hospice payment regulations that the physician member of the interdisciplinary group (IDG) may recommend admission to hospice care, which would align with certification regulations and the Conditions of Participation (CoPs).
4. CMS also proposes to clarify that the hospice face-to-face encounter attestation must include the physician’s/practitioner’s signature and date.
5. In addition, CMS proposes to provide a regulatory text change for the Hospice Quality Reporting Program.
6. The final rule can be viewed at the Federal Register at: https://www.federalregister.gov/public-inspection.