Hospice Payment and Quality Updates 2026
Summary
This final rule updates the hospice wage index, payment rates, and aggregate cap amount for Fiscal Year (FY) 2026. This rule also finalizes changes to the admission to hospice regulations and the hospice face-to-face attestation requirements under the certification of terminal illness regulations and includes technical changes to the hospice telehealth policy and wage index. This final rule also includes a technical correction to the regulatory text and provides updates to the Hospice Quality Reporting Program requirements.
Compliance Requirements
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Updates to the hospice wage index and makes the application of the updated wage data budget neutral for all four levels of hospice care.; Final FY 2026 hospice payment update percentage of 2.6 percent.; Final FY 2026 hospice payment rates.; Final update to the hospice cap amount for FY 2026 by the hospice payment update percentage of 2.6 percent.; Specifies that the physician member of the interdisciplinary group is among the types of physicians who can recommend a patient’s admission to hospice care and adds the physician member of the interdisciplinary group to the regulatory text at § 418.25.; Re-aligns the attestation requirements in the regulatory text at § 418.22(b)(4) with the original intent of the statutory requirements under section 1814(a)(7) of the Act and CY 2011 HH PPS final rule for the certification of terminal illness regulations to include the physician’s or nurse practitioner’s signature and the date of the signature on each face-to-face encounter attestation.; Includes a technical correction to the regulatory text at § 418.22(a)(4)(ii) that extends the use of telehealth by a hospice physician or hospice nurse practitioner to conduct a face-to-face encounter for the sole purpose of hospice recertification through September 30, 2025 in accordance with section 1814(a)(7)(D)(i)(II) of the Act, as amended by section 2207(f) of the Full-Year Continuing Appropriations and Extensions Act, 2025 (Pub. L. 119-4).; Includes a technical correction to a typographical error in the FY 2024 Hospice final rule at § 418.312(j).
Deadline: 2025-10-01(October 1, 2025)
Market Impacts
Final FY 2026 hospice wage index and rate update including a 2.6 percent payment update percentage.; Amendment to payment regulations to specify that the physician member of the hospice interdisciplinary group (IDG) may recommend admission to hospice.; Technical correction to the regulatory text at § 418.22(a)(4)(ii) extending the use of telehealth for hospice recertification through September 30, 2025.; Updates to the Hospice Quality Reporting Program (HQRP) requirements, including the transition to the HOPE instrument and iQIES.
Validated Company Impacts
Acadia Healthcare Company, Inc.
Acadia Healthcare operates behavioral health facilities and addiction treatment centers, not hospice care services. The company's business model focuses on psychiatric hospitals, residential treatment centers, and outpatient clinics, with no mention of hospice or end-of-life care in their operations. The rule directly impacts Medicare reimbursement rates and policies, which aligns perfectly with the company's identified 'Medicare and Medicaid Reimbursement Risks' risk factor. This rule specifically updates hospice payment rates and wage index, creating material financial exposure for companies dependent on Medicare revenue.
AMEDISYS INC
Amedisys Inc operates a dedicated hospice segment that provides end-of-life care services, which directly falls under the jurisdiction of this Medicare hospice rule. The company's hospice operations would be significantly affected by all aspects of the rule including payment rate updates, wage index changes, quality reporting requirements, and telehealth policy modifications. The Medicare hospice rule focuses on payment updates, quality reporting, and operational requirements specific to hospice providers, while the company's disclosed risks center on merger-related legal, financial, and integration challenges with no mention of healthcare operations or Medicare compliance. There is minimal overlap as the rule addresses clinical and reimbursement risks that are not reflected in the company's risk profile.
BrightSpring Health Services, Inc.
BrightSpring Health Services operates primarily in pharmacy services, home health care, and behavioral health, with no mention of hospice care services in their business operations. The federal rule specifically targets hospice providers for payment updates, quality reporting, and regulatory changes, which does not align with BrightSpring's disclosed business segments. The rule directly impacts Medicare reimbursement rates and regulatory requirements for hospice care, which aligns perfectly with the company's identified risks of changes in Medicare/Medicaid rates and regulatory changes in healthcare. These are among the company's top financial and regulatory risks, indicating significant exposure to this rule's provisions.
UNIVERSAL HEALTH SERVICES INC
Universal Health Services operates acute care hospitals and behavioral health facilities, but does not provide hospice care services. The federal rule specifically targets hospice providers for payment updates, wage index adjustments, and quality reporting requirements, which have no relevance to UHS's hospital and behavioral health operations. The rule directly impacts hospice payment rates, wage index updates, and quality reporting requirements, which aligns strongly with the company's identified regulatory risks (10 risks) and operational risks (21 risks) related to healthcare law changes and personnel cost pressures. The payment rate updates and compliance requirements specifically address the company's concerns about increased expenses and regulatory changes affecting financial operations.
CHEMED CORP
VITAS, Chemed's primary revenue-generating segment, operates exclusively in hospice care services with over 95% of revenue from Medicare/Medicaid programs, directly aligning with all aspects of this Medicare hospice payment and quality reporting rule. The rule's wage index updates, payment rate changes, telehealth provisions, and quality reporting requirements directly impact VITAS's core hospice operations and reimbursement structure. The federal rule exclusively targets hospice care providers with specific Medicare payment updates, wage index adjustments, and quality reporting requirements. The company operates in the automotive industry with no disclosed healthcare operations, hospice services, or Medicare-related risks, resulting in zero alignment with this rule's scope.
Option Care Health, Inc.
Option Care Health operates exclusively in infusion therapy services, not hospice care. The federal rule specifically targets hospice providers for payment updates, quality reporting, and admission requirements, which have no relevance to infusion therapy operations. The rule directly impacts hospice payment rates and reimbursement structures, which aligns perfectly with the company's identified risk of 'Dependency on third-party payers' and potential adverse effects from changes in reimbursement rates. Additionally, the regulatory changes and quality reporting requirements directly correspond to the company's 'Healthcare regulatory changes' risk, indicating significant compliance and operational impacts.
Surgery Partners, Inc.
Surgery Partners operates surgical facilities and related healthcare services but does not provide hospice care, which is the exclusive focus of this Medicare rule. The company's business model centers on surgical procedures, anesthesia, and diagnostic services rather than end-of-life hospice care covered by this regulation. The rule directly impacts hospice payment rates and regulatory requirements, which strongly aligns with the company's identified 'Revenue Concentration' risk (susceptibility to reimbursement rate changes) and 'Healthcare Regulations' risk (regulatory changes imposing additional costs and operational constraints). These are material financial and regulatory compliance risks that would be significantly affected by this Medicare hospice payment update rule.