Volume 25.08
On August 1, 2025, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (CMS-1835-F) that updates Medicare hospice payment rates and the aggregate cap amount for fiscal year (FY) 2026, which begins on October 1, 2025, in accordance with existing statutory and regulatory requirements.
The rule finalizes in the hospice payment regulations that the physician member of the interdisciplinary group (IDG) may recommend admission to hospice care, which aligns with the certification of terminal illness payment regulations and medical director Conditions of Participation (CoPs) regulations. The rule also clarifies that hospice face-to-face encounter attestations must include the signature and date of the signature of the physician or nurse practitioner and adds additional flexibility by allowing a signed and dated clinical note to satisfy the attestation requirement.
In addition, the rule finalizes a regulatory text change for the Hospice Quality Reporting Program.
For FY 2026, CMS will update the hospice payment rate by 2.6% (an estimated increase of $750 million in payments from FY 2025). This results from the 3.3% inpatient hospital market basket percentage increase reduced by a proposed 0.7 percentage point productivity adjustment, required by law. The FY 2026 rates for hospices that do not submit the required quality data would reflect the FY 2026 hospice payment update percentage of 2.6% minus four percentage points as required by law, which would result in a 1.4% reduction over the previous year’s payment rate.
National payment rates, before geographical adjustment are as follows for hospices submitting quality data, effective October 1, 2025:
Routine home care (days 1-60) $ 230.83
Routine home care (days 61+) $ 181.94
Continuous home care (hourly) $ 69.76
Inpatient respite care (per-day) $ 532.48
General inpatient care (per-day) $ 1,199.86
Hospice payments are subject to a statutory aggregate cap, which limits the overall payments made to a hospice annually. The hospice cap amount for FY 2026 is $35,361.44 (FY 2025 CAP amount of $34,465.34 increased by the FY 2026 hospice payment update percentage of 2.6%).
To correct an inadvertent regulatory omission in the FY 2012 hospice final rule, this final rule amends § 418.22(b)(4) to restore the signature and date requirements for the face-to-face attestation. Additionally, in response to commenter concerns, CMS is finalizing changes to reduce administrative burden by also eliminating the requirement that the attestation must be a separate and distinct document and clarifying that the attestation requirement may be fulfilled not only as either a clearly titled section of or an addendum to the recertification form, but also as part of a signed and dated clinical note within the medical record.
No changes were made regarding the submission of accurate and complete HOPE data beginning on October 1, 2025, and the rule makes a technical correction extending the use of telehealth by a hospice physician or hospice nurse practitioner for the sole purpose of hospice certification through September 30, 2025. The final rule is available here.
2025 HOSPICE FINANCIAL ADMINISTRATION CONFERENCE FILLING EARLY
Early registration is still being accepted for the 2025 Hospice Financial Administration Conference, scheduled for October 16-17, 2025, at the Hilton Orlando Lake Buena Vista – Disney Springs Area. Special rates have been secured with the hotel for conference attendees.
In response to feedback from prior program attendees, several topics have been expanded, and concurrent programming is available to facilitate meeting the needs of the attendees, whether administrative management, accounting management and personnel, or those more interested in clinical services management or program integrity issues.
The program offers an expanded breakout Hospice CAP session and cost report session in response to requests by previous attendees. As always, space is limited at our programs to provide for more interactive discussions intended to meet your educational needs.
The program agenda, hotel reservation link, and registration information are available here. Early registration discounts are available through August 15, 2025. We look forward to seeing you in Orlando.