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 |
Code |
Base Rate |
Labor / Non-Labor |
Wage Index |
Adjusted Rate |
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 base rate trends FY 2020–2026 for all four levels of care. Select a CBSA to overlay wage-adjusted local rates.
National Base Rates — All Years
| FY | RHC 1–60 | RHC 61+ | CHC (24hr) | GIP | IRC | Agg. Cap | Update % |
|---|
⚑Chart shows compliant-rate national base rates. CHC displayed as 24-hour equivalent per-diem (hourly rate × 24). Local overlay uses the wage index for the selected CBSA for the displayed fiscal year.
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.
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.
The Service Intensity Add-On (SIA) provides additional payment for RN and Social Worker visits in the last 7 days of life while the patient is receiving Routine Home Care (RHC). SIA equals the CHC hourly rate × hours of care (up to 4 hours/day).
SIA Inputs
Hours per Day — Last 7 Days of Life (0–4 hrs/day per RN/SW)
CHC Hourly Rates (= SIA Rate) — All Years
| FY | CHC Hourly Rate | Max Daily SIA (4 hrs) | Max 7-Day SIA |
|---|
⚑SIA is paid in addition to the regular RHC per diem. Eligible visits must be provided by an RN or Social Worker; aide visits do not qualify. The SIA rate equals the CHC hourly rate. Verify eligibility criteria with your MAC. Patient must be in the last 7 days of life and receiving RHC at time of service.