Spotlight
FY 2026 Hospice Proposed Rule
In the FY 2026 hospice proposed rule, the hospice wage index, payment rates, and aggregate cap amount are updated. Additionally, this rule proposes changes to the admission to hospice regulations and the hospice face-to-face attestation requirements under the certification of terminal illness regulations. This proposed rule also includes a technical correction to the regulatory text and provides updates to the Hospice Quality Reporting Program requirements. Finally, this proposed rule solicits comments regarding requests for information surrounding future measure concepts for Hospice Quality Reporting Program.
Section 2207 of the Full-Year Continuing Appropriations Act, 2025 extended the use of telehealth by a hospice physician or hospice nurse practitioner to conduct a face-to-face encounter for the sole purpose of hospice recertification. This extension is through September 30, 2025. This constitutes a temporary change in the regulations at 42 CFR 418.22(a)(4)(ii).
Starting October 1, 2024, hospices that provide services in certain counties must use a transition code (500XX codes) on hospice claims instead of the rural area or CBSA code in circumstances where a county was redesignated into a new CBSA or rural area and has a different wage index than the constituent counties that make up that CBSA or rural area due to the 5-percent cap on wage index decreases policy. Table 8 of the FY 2025 Hospice final rule (89 FR 64221) lists these counties that will require a transition code beginning in FY 2025. However, FIPS 09150 Northeastern Connecticut planning region was inadvertently left off the list. We are in the process of issuing a correction notice in the federal register to update Table 8 with the correct transition code for the Northeastern Connecticut planning region. Please check the Hospice Center webpage as we will update here once the correction notice has been issued.
Hospice Monitoring Report
The Medicare Fee-for-Service (FFS) hospice benefit provides palliative services for pain and symptom management, as well as emotional and spiritual supportive services, to beneficiaries who are terminally ill with a prognosis of six months or less. Within this monitoring report (PDF) we examine who is using the Medicare FFS hospice benefit and how it is being used. Specifically, we focus on hospice utilization from Federal Fiscal Years (FYs) 2020 – 2024.
Contact Us
For questions about hospice payment policy, send your inquiry via email to: hospicepolicy@cms.hhs.gov.
