Select a fiscal year and geography to calculate wage-adjusted per diem hospice rates for all four levels of care. Hospice FY runs October 1 – September 30.
| Level of Care |
Rev Code |
Base Rate |
Labor / Non-Labor |
Wage Index |
Adjusted Rate |
Estimate only — verify with your MAC before billing
Enter a 5-digit CBSA code or search by city above to see wage-adjusted rates. Without a selection, rates shown are national unadjusted (wage index = 1.0000).
⚑Rates shown are for hospices that submit required quality data (HQRP). Non-compliant hospices receive a 4-percentage-point reduction to the annual payment update beginning FY 2024 (previously 2-point reduction FY 2020–2023). Geographic adjustment is based on the beneficiary’s location for RHC/CHC and the facility location for GIP/IRC. Rates sourced from CMS Final Rules; verify with your MAC before billing.
National hospice payment rates FY 2020–2026. Year-over-year change shown per level of care. Select a CBSA to add the local wage index column.
Rate Trends — FY 2020–2026
⚑Rates are national base rates from CMS Final Rules. YOY Δ calculated per level of care — each LOC moves by a different percentage due to separate wage index standardization factors. Select a CBSA to apply wage adjustment across all years. Click any cell to see the full payment calculation for that level of care and year. Click a sparkline to view the full trend chart.
Estimate total Medicare payment for a single patient stay. Enter days at each level of care and RN/SW visit hours in the last 7 days of life. Rates are wage-adjusted if a CBSA is selected.
Payment Summary
Estimate only — verify with your MAC before billing
Days by Level of Care & SIA Hours
| Level of Care |
Rate |
Days / Hours |
Subtotal |
⚑RHC Days 1–60 rate applies to the first 60 days of continuous hospice enrollment. Days 61+ rate applies thereafter. CHC, GIP, and IRC are paid per diem at separate rates. SIA is paid in addition to the RHC per diem for RN/SW visits in the last 7 days of life (up to 4 hours/day). Rates sourced from CMS Final Rules; verify with your MAC.
The Medicare hospice aggregate cap limits total annual payments per patient. If a hospice’s total Medicare payments exceed the cap amount × number of Medicare patients served, the overage must be repaid. The cap year runs November 1 – October 31.
Estimate only — contact your MAC to confirm cap status
Utilization vs. Cap Threshold
Historical Cap Amounts
| FY | Cap Amount | Update % | FR Document |
|---|
⚑The aggregate cap is not adjusted for geographic differences in wages. The cap amount is multiplied by the hospice’s total Medicare patients served in the cap year (Nov 1 – Oct 31). Medicare Administrative Contractors (MACs) determine final cap status. Consult your MAC or a billing specialist before relying on these estimates.
Historical comparison of CMS proposed vs. final hospice payment rates, and a projection tool for estimating where FY 2027 final rates may land once the proposed rule is seeded into the database.
Proposed vs. Final — Payment Update %
Final minus Proposed, in percentage points
Proposed vs. Final — Base Rates by LOC
Wage Index — Proposed vs. Final
⚠Proposed rules are published each spring (typically April–May) and finalized in August. The delta between proposed and final varies year to year due to wage index standardization, market basket revisions, and behavioral adjustments. FY 2023 was a significant outlier (+1.1pp) due to CMS correcting prior behavioral adjustment methodology. Projections are statistical estimates only — not a forecast of CMS policy.