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
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.
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.
Geography
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.
Stay Inputs
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
| 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.