CMS Issues Final FY 2026 Hospice Payment Rule

The Situation Report | August 4, 2025

The U.S. Centers for Medicare and Medicaid Services (CMS) has released its hospice final rule (CMS–1835-P) to update the Fiscal Year (FY) 2026 (October 1, 2025 through September 30, 2026) Medicare payment rates and the wage index for hospices serving Medicare beneficiaries.

The final rule is available here.

CMS estimates a 2.6% ($750 million) market basket increase in national hospice payments for FY 2026 over FY 2025. CMS also updates the Routine Home Care (RHC), Continuous Home Care (CHC), Inpatient Respite Care (IRC) and General Inpatient Care (GIC) hospice Medicare rates for FY 2026.

In addition to the market basket increase and payment updates, the rule contains the following other updates:

• An updated FY 2026 Hospice Wage Index, including the finalized 5% cap on negative wage index changes, is available here.
• A final FY 2026 aggregate cap amount of $35,361.44.
• Hospice Admission Recommendations: CMS updates 42 C.F.R. § 418.25 to add “physician member of the hospice interdisciplinary group” as a physician who can make a recommendation for admission to hospice.
• Face-to-Face (F2F) Encounter Attestation Requirements: Rather than finalize its proposal to revise face-to-face attestation requirements at 418.22(b)(4) to explicitly require the signature and date of signature on the face-to-face encounter, CMS will now allow a signed clinical note to serve as the attestation that a hospice physician or nurse practitioner completed the face-to-face encounter and the date completed. 
• Hospice Outcomes and Patient Evaluation (HOPE) Tool: CMS is moving forward with its decision to implement the HOPE tool with data collection beginning October 1, 2025.

HCANYS' Vice President of Finance and Management, Patrick Conole, will analyze the final rule and provide our hospice members with a detailed memorandum on the specifics of the rule this week.