Hospices are expected to see a pay increase later this year, according to the fiscal year 2026 Hospice Payment Rate Update proposed rule, released Friday, April 11, 2025. 
  
The proposed rule includes a hospice payment update of 2.4% beginning in October 2025. The payment update would mean an estimated $695 million in increased payments to hospices, according to CMS. 
 
The proposed aggregate cap per patient would be $35,292.51, up from the fiscal year 2025 cap of $34,465.34. These numbers often change slightly before the final rule is released in the summer based on updated data. 
 
In response, the National Alliance for Care at Home said the payment update fails to address financial pressures on hospice providers nationwide, including inflation, workforce shortages and rising expenses for supplies and services.  
 
"The proposed payment update for FY 2026 falls short of what is needed to sustain high-quality hospice care,” said Dr. Steve Landers, CEO of the Alliance. “Without meaningful adjustments, hospices across the country will face serious challenges—jeopardizing access to care for terminally ill patients and placing added strain on families already facing the unimaginable."
 
The rate update is lower than the 2.9% increase for fiscal year 2025.
 
The proposed rule also would “realign the attestation requirements in the regulatory text,” stating that the physician or nurse practitioner who conducts the face-to-face encounter must include their signature and the date of the signature. 
 
The attestation, its accompanying signature and the date signed must be a separate and distinct section of, or an addendum to, the recertification form, and must be clearly titled, according to the proposed rule.
 
Other details in the proposed rule:  
  • Provides clarification in payment regulations that the physician member of the hospice interdisciplinary group may recommend admission to hospice. 
  • Includes a request for information on approaches and opportunities to meet the Trump administration goal of “streamlining regulations and reducing burdens on those participating in the Medicare program.” 
  • Reiterates implementation of the Hospice Outcomes and Patient Evaluation (HOPE) tool will be Oct. 1, 2025, with public reporting no earlier than Oct. 1, 2027. 
  • Seeks feedback on hospice use of IT systems in documentation and data submission, as well as potential quality measures around interoperability, nutrition and well-being. And a request for information on advancing digital quality measurement.
See upcoming issues of Home Health Line for more coverage of the proposed rule. 
   
See the proposed rule at the Federal Register at https://public-inspection.federalregister.gov/2025-06317.pdf.