Hospice Proposed Rule 2026
CMS Releases Fiscal Year (FY) 2026 Hospice Wage
Index and Payment Rate Update (from Alliance Daily)
HIGHLIGHTS:
Proposed payment update, hospice cap amount
Admission recommendations, F2F encounter requirements
Estimated $695 million in increased payments relative to FY2025
On April 11, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2026 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program proposed rule. CMS has also released a fact sheet accompanying the proposed rule. The National Alliance for Care at Home (Alliance) issued a statement in response.
Key provisions include:
Proposed Payment Rate Update. CMS is proposing a 2.4% increase for FY 2026, which reflects a 3.2% market basket percentage increase, decreased by a 0.8 percentage point productivity adjustment.
Proposed Hospice Cap Amount. CMS proposes a hospice cap amount for the FY 2026 cap year of $35,292.51, which is equal to the FY 2025 cap amount ($34,465.34) updated by the proposed FY 2026 hospice payment update percentage of 2.4%.
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 Encounter Attestation Requirements: CMS proposes to revise face-to-face 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 face-to-face 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.
Comments on the proposed rule are due by June 30, 2025. The overall impact of the rule is an estimated $695 million in increased hospice payments relative to FY 2025.
Click here to read the National Alliance's analysis of the rule.
Thanks,
Carol Hudspeth
Executive Director
