Cms Final Rule Delivers ‘insufficient’ 2.6% Increase In Hospice Medicare Payments

On Friday, the U.S. Centers for Medicare & Medicaid Services issued a final rule increasing hospice Medicare base rate payments by 2.6%.

This is more than the 2.4% that the agency originally proposed in April. The 2026 increase in aggregate represents a $750 million jump in federal hospice spending. The aggregate hospice payment cap also increased 2.6% to $35,361.44 in 2026, according to the final rule.

The 2.6% pay hike remains “insufficient” for hospice providers who are facing a range of rising costs, according to Dr. Steve Landers, CEO of the National Alliance for Care at Home.

“While the finalized 2.6% payment update is still insufficient for providers that face persistent inflationary forces amid an ongoing nationwide healthcare workforce crisis, we recognize CMS’s incorporation of Alliance feedback to help streamline regulatory requirements,” Landers said in a statement shared with Hospice News. “We will continue to partner with CMS to advocate for home-based care rulemaking that focuses on comprehensive long-term strategy to best serve both the American people and the Medicare trust fund. Evidence consistently demonstrates that hospice care aligns with patient and family preferences and saves the American health care system money.”

While payment increase is welcome news, many hospices are still struggling in today’s economic environment, according to Tom Koutsoumpas, CEO of the National Partnership for Healthcare and Hospice Innovation (NPHI).

“NPHI is pleased to see CMS confirm a payment rate increase for hospices across the US. In the current environment, even a modest increase provides some relief and stability for providers,” Koutsoumpas told Hospice News in an email. “At the same time, nonprofit, mission-driven, community-based hospice organizations continue to face real financial and workforce pressures as they work to deliver high-quality, person-centered care.”

The final rule also indicated that the physician member of the interdisciplinary group (IDG) may recommend admission to hospice care, which aligns Conditions of Participation and Conditions of Payment.

The rule also clarifies that hospice face-to-face encounter attestations must be signed and dated by a physician or nurse practitioner. Clinicians can satisfy this requirement through the use of a signed and dated clinician note, according to the final rule.

CMS seems set on an Oct. 1 implementation date for the Hospice Outcomes and Patient Evaluation (HOPE) tool quality measurement system, despite calls for a delay. The final rule did not make any changes to the transition deadline.

“HOPE will provide assessment-based quality data to enhance the HQRP through standardized data collection, provide a better understanding of patient care needs, contribute to the patient’s plan of care, and provide additional clinical data that could inform future payment refinements,” CMS indicated in the rule language.

The Alliance voiced dismay that the HOPE implementation date was not moved.

“Despite responsiveness in other areas, the Alliance is deeply disappointed that CMS did not heed recommendations and delay the Oct. 1, 2025 implementation of the [HOPE] tool nor waive the timeliness completion requirement for HOPE record submission,” the Alliance indicated in a statement. “We expect providers to face a burdensome transition and urge CMS to remain responsive to real-world challenges, offering flexibility as providers navigate the change.”

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