CMS Proposes FY 2026 Hospice Payment and Policy Updates

On April 11, the Centers for Medicare & Medicaid Services (CMS) released its Hospice proposed rule, updating Medicare hospice payment rates and policies for Fiscal Year 2026. These changes, if finalized, will have a direct impact on agencies providing hospice care.



Key Highlights Include:

• Payment Update: A proposed 2.4% increase in payment rates, which equates to approximately $695 million in additional payments system-wide.
• Quality Data Penalty: Providers that fail to meet Hospice Quality Reporting Program (HQRP) requirements would see a 4% penalty, leading to an effective 1.6% decrease in payments compared to FY 2025.
• Aggregate Cap: Proposed cap set at $35,292.51, up from $34,465.34 in FY 2025.
• Regulatory Clarifications:
• Hospice physicians who are part of the interdisciplinary group (IDG) may now recommend admissions.
• Face-to-face encounter attestations must include both a signature and date from the physician or practitioner.
• HQRP Updates:
• CMS is preparing to launch the HOPE tool on October 1, 2025.
• Seeking input on future quality measures and adoption of health IT standards, including FHIR.
• Reducing Administrative Burden: CMS is requesting public feedback on how to streamline and simplify existing hospice regulations, in line with a recent Executive Order.

FY 2026 Proposed Hospice Wage Index

For further information, see the CMS Hospice Webpage.