Skip to main content

CMS Issues Proposed FY 2026 Hospice Payment Rule

The Situation Report | April 14, 2025

HCA to Host Hospice Connects Meeting April 16

The U.S. Centers for Medicare and Medicaid Services (CMS) has released its hospice proposed 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 proposed rule is on display for public inspection here.

In the rule, CMS is proposing a 2.4 percent ($695 million nationally) market basket increase in national hospice payments for FY 2026 over FY 2025. CMS 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 available here.
  • A final FY 2026 aggregate cap amount of $35,292.51.
  • Hospice Admission Recommendations: CMS proposes to update 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: CMS proposes to revise the F2F attestation requirements at § 418.22(b)(4) to explicitly require the signature and date of signature on the attestation that a physician or nurse practitioner (NP) conducted a F2F encounter.
  • Request for Information. The proposed rule includes two requests for information to Advance Digital Quality Measurement (dQM) in the HQRP and Future Quality Measure Concepts for the HQRP. CMS also references a separate Deregulation request for information to solicit stakeholder feedback on approaches that would reduce provider burdens in alignment with the objectives outlined in Executive Order 14094.

HCANYS has prepared an overview of the highlights available here. 

HCANYS along with representatives of the our national affiliate, the National Alliance for Care at Home, and HCANYS hospice members will be convening in a special meeting this Wednesday, April 16, from 10:30 – 11:30 to review and garner initial input on this hospice rule, along with a discussion of the Hospice Outcomes and Patient Evaluation (HOPE) Tool.

HCANYS Hospice members and staff, please register here.