Medicare Updates hospice Payments: What Providers & Patients Need to Know (2026)
Published August 4, 2025 | Updated august 7, 2025
Teh landscape of hospice care is constantly evolving, adn recent changes announced by the U.S. Centers for Medicare & Medicaid Services (CMS) will substantially impact both providers and the patients they serve. on Friday, CMS released it’s final rule outlining updates to Medicare hospice payments for 2026, alongside clarifications regarding operational requirements and the impending rollout of a new quality measurement system. This article provides a comprehensive breakdown of these changes,offering insights into what they mean for the future of hospice care in the United states.
A Modest Payment Increase: 2.6% for 2026
Hospice providers will see a 2.6% increase in Medicare base rate payments in 2026. This represents a slight uptick from the 2.4% originally proposed in April, translating to a $750 million increase in federal hospice spending overall. The aggregate hospice payment cap will also rise, reaching $35,361.44 in 2026.
While any increase is welcome, industry leaders emphasize that this adjustment falls short of addressing the important financial pressures currently facing the hospice sector. “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,” stated Dr. Steve Landers, CEO of the National Alliance for Care at Home. “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.”
The Financial Reality for Hospice Providers
The sentiment is echoed by 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,” he explained. However, he underscored the ongoing challenges faced by non-profit, community-based hospices, particularly concerning financial sustainability and workforce recruitment. These organizations are dedicated to providing high-quality, person-centered care, but are increasingly strained by rising costs and a shrinking pool of qualified professionals.
Key Regulatory Clarifications: Streamlining Care Delivery
Beyond the payment adjustments, the final rule includes significant clarifications designed to streamline hospice operations and improve care coordination:
Physician Role in Admission: The rule explicitly states that the physician member of the Interdisciplinary Group (IDG) can now recommend admission to hospice care. This aligns Conditions of Participation and Conditions of Payment, simplifying the process for patients seeking end-of-life care.
Face-to-Face Encounter Attestations: CMS has clarified the documentation requirements for face-to-face encounters. Attestations can now be fulfilled with a signed and dated clinician note, offering flexibility for physicians and nurse practitioners. This reduces administrative burden while ensuring proper documentation of patient needs.
the looming Deadline for the HOPE Tool: Concerns Remain
Despite repeated requests for an extension, CMS remains firm on its October 1, 2025 implementation date for the Hospice outcomes and Patient Evaluation (HOPE) tool. This new quality measurement system aims to provide assessment-based quality data, standardize data collection, and ultimately inform future payment refinements.
CMS believes HOPE will “provide a better understanding of patient care needs, contribute to the patient’s plan of care, and provide additional clinical data.” However, the National Alliance for Care at Home has expressed significant concerns.
“Despite responsiveness in othre 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 stated. Providers fear a burdensome transition and are urging CMS to remain flexible and responsive to real-world challenges as they navigate this significant change. The Alliance anticipates difficulties in meeting the tight deadline and ensuring accurate data submission.
What This Means for Patients and Families
These changes, while largely focused on the operational and financial aspects of hospice care, ultimately impact the patients and families who rely on these vital services. A stable hospice system, supported by adequate funding and streamlined regulations, is crucial for ensuring access to compassionate, high-quality end-of-life care.
The clarifications regarding physician
