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CMS Proposes FY 2026 Hospice Payment and Policy Updates

CMS Proposes FY 2026 Hospice Payment and Policy Updates

Key Proposed Changes to Hospice Payment and Policies for FY 2026

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.

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