Hospice providers get 2.6% pay boost in CMS rule

Hospices will get a 2.6% pay increase for 2026 in the Centers for Medicare and Medicaid Services’ Hospice Quality Reporting Program (HQRP) final rule.

The bump represents an estimated increase of $750 million in payments when compared to the current fiscal year. This results from the 3.3% inpatient hospital market basket percentage increase reduced by a proposed 0.7 percentage point productivity adjustment, required by law.

The FY 2026 rates for hospices that don’t submit the required quality data would reflect the FY 2026 hospice payment update percentage of 2.6% minus four percentage points, which would result in a 1.4% reduction over the previous year’s payment rate, said CMS.

Hospice payments are subject to a statutory aggregate cap, which limits the overall payments made to a hospice annually. The hospice cap amount for FY 2026 is $35,361.44.

WHAT’S THE IMPACT

The payment increase is more than the 2.4% that the agency originally proposed in April but it remains “insufficient” for hospice providers who are facing a range of rising costs, according to Dr. Steve Landers, CEO of the National Alliance for Care at Home.

The rule also finalizes changes to hospice payment regulations, allowing physician members of interdisciplinary groups to recommend admission to hospice care. 

CMS also restored the signature and date requirements for the face-to-face attestation – an amendment of what the agency called an "inadvertent regulatory omission” in the FY 2012 hospice final rule. 

And in response to concerns from commenters, CMS is eliminating the requirement that the attestation must be a separate and distinct document, and clarifying that the attestation requirement can be fulfilled not only as either a clearly titled section of or an addendum to the recertification form, but also as part of a signed and dated clinical note within the medical record. 

THE LARGER TREND

In the final rule, CMS corrected a typographical error in the regulations regarding implementation of the Hospice Outcomes and Patient Evaluation (HOPE) tool and reviewed input for two RFIs regarding future quality measure concepts and advancing digital quality measurement for HQRP.