Volume 25.05
On Friday, April 11, 2025, the U.S. Centers for Medicare & Medicaid Services (“CMS”) released the Fiscal Year (FY) 2026 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program proposed rule.
For the 2026 fiscal year, beginning October 1, 2025, CMS proposes to update the base hospice payment rate by 2.4%. This rate increase is based on the proposed 3.2% inpatient hospital market basket percentage increase reduced by a proposed .8% productivity adjustment. Hospices not submitting required quality data would be subject to a 4% reduction to the update percentage, meaning that base rates would decrease by 1.6%.
Proposed base hospice rates for those hospices submitting quality data as required, subject to geographical adjustment, are as follows:
Routine home care (days 1-60) $ 230.33
Routine home care (days 61+) $ 181.51
Inpatient respite care $ 531.60
General inpatient care $1,197.40
Continuous care (hourly) $ 69.38
The aggregate payment limitation (“CAP”) is proposed at $35,292.51 from the current amount of $34,465.34.
In addition to payment modifications, the proposed rule includes the following key provisions:
- 42 C.F.R. §418.25, which addressed hospice admissions, will add “physician member of the hospice interdisciplinary group” as a physician who can make a recommendation for admission to a hospice.
- Face-to-face attestation requirements would be revised to explicitly require the signature and date of signature on the attestation that a physician or nurse practitioner conducted a face-to-face encounter.
CMS has included requests for information in the proposed rule. These are:
- Feedback on approaches that would reduce provider burdens consistent with the objectives outlined in Executive Order 14094, which seeks to reduce administrative complexity and streamline regulations.
- Input on advancing digital quality measurement, specifically relating to the use of information technology.
- Importance, relevance, appropriateness, and applicability of concepts under consideration in the Hospice Quality Reporting Program (“HQRP”).
The proposed rule is available here.
ROOM RESERVATIONS AVAILABLE FOR 2025 HOSPICE FINANCIAL ADMINISTRATION CONFERENCE
The 2025 Hospice Financial Administration Conference is scheduled for October 16-17, 2025, at the Hilton Orlando Lake Buena Vista – Disney Springs Area. Attendees can now make room reservations at the discounted rate here.
The program is being finalized currently; however, for those who are planning to attend we encourage making early reservations. Space is limited at all programs sponsored by The Health Group, LLC to enhance the quality of the educational programs and networking between participants.