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CMS Proposes FY 2027 Hospice Payment and Oversight Updates

CMS Proposes FY 2027 Hospice Payment and Oversight Updates

Modest rate increase paired with new scrutiny on utilization, reporting, and care delivery

Federal Policy Update

CMS Releases FY 2027 Hospice Proposed Rule

CMS has issued its proposed rule for FY 2027 hospice payment updates and quality reporting, outlining changes to reimbursement, transparency, and care delivery requirements.

The proposal includes a modest payment increase, new reporting tools to identify outliers, and operational changes that would affect documentation, discharge authority, and compliance expectations.

Published April 2026

On April 2, 2026, CMS released its proposed rule for FY 2027 hospice payment updates and quality reporting requirements, along with a supporting fact sheet.

The proposal includes a 2.4% payment increase, reflecting a 3.2% market basket update reduced by a 0.8% productivity adjustment, and raises the hospice cap to $36,210.11.

  • 2.4% proposed payment increase for FY 2027
  • $36,210.11 updated hospice cap
  • $785 million estimated total payment increase
  • Comments due June 1, 2026

CMS also introduces a new Service and Spending Variation Index (SSVI) to identify outlier hospices based on utilization and non-hospice spending.

Additional proposals would require delivery of the election statement addendum at the time of hospice election beginning October 1, 2026, and allow greater flexibility in discharge authority and telehealth face-to-face requirements.

The introduction of SSVI signals increased focus on utilization patterns and spending variation, with potential implications for oversight and program integrity.

The rule confirms all 2025 HOPE submissions as timely and proposes adding a public indicator on Medicare.gov for failure to meet reporting requirements.

CMS is also seeking input on expanding community-based palliative care, developing a hospice-specific wage index, and addressing overlap with Medical Aid in Dying.

Comments on the proposed rule are due June 1, 2026.

Source: CMS FY 2027 Hospice Proposed Rule and fact sheet.
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