On July 30, 2026, CMS issued the Medicare hospice final rule (CMS-1851-F), which updated the payment rate by 2.3% (or a $755 million estimated increase). This increase includes the 3.2% inpatient hospice market basket updated with a 0.9% productivity reduction. The final fiscal year (FY) 2027 standardized payment rates for each level of care are shown below.
| Level of Care | Daily Payment Rate |
|---|---|
| Routine Home Care (days 1-60) | $236.35 |
| Routine Home Care (days 61+) | $186.35 |
| Continuous Home Care | $1,726.50 |
| Inpatient Respite Care | $545.98 |
| General Inpatient Care | $1,231.63 |
Source: https://www.federalregister.gov/d/2026-15686
While the FY 2027 final rule includes a modest payment increase, CMS continues to emphasize transparency, quality reporting, and oversight of hospice utilization and spending.
The hospice statutory aggregate cap amount was also increased by 2.3%, which was finalized at $36,174.75 for FY 2027.
The final rule will implement the Service and Spending Variation Index (SSVI), which is a scoring system to analyze claims-based data under a hospice election and publicly release provider-level data with the goal of oversight for non-hospice spending. The SSVI tracks nine claims-based measures to evaluate hospice services and rank providers. The rankings are intended to help beneficiaries compare providers and make informed care decisions, while also supporting program integrity.
CMS also finalized requirements for hospices to provide the hospice election statement addendum to all Medicare beneficiaries at the time of election. This is a change from providing the addendum to the beneficiaries only when requested. The goal of this change is to improve transparency for non-covered services and help align treatment with the intended care to potentially reduce total spending.
Included in the final rule is the implementation of an additional icon on the Medicare.gov Care Compare to identify hospices that do not submit the required quality data through the Hospice Outcomes and Patient Evaluation (HOPE) tool.
The rule revises the hospice telehealth face-to-face recertification policy to align with current statutory requirements. The changes address the telehealth end date, require the use of specific modifiers or codes for these encounters, and prohibit the use of telehealth for face-to-face visits in certain moratorium-related situations.
The final rule is effective on October 1, 2026, but the time is now to evaluate operational and compliance processes to understand how the final rule will impact your hospice.
If you have any questions or need assistance, please reach out to a Home Care & Hospice advisor at Forvis Mazars.