Medicare Hospice Payment Calculator

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.

Calculator Inputs
Geography (CBSA / Wage Index)
Wage-Adjusted Rates by Level of Care
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.

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.

Stay Inputs
Geography (CBSA / Wage Index)
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.

Cap Year & Agency Inputs
Historical Cap Amounts
FYCap AmountUpdate %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.