United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information 2026_register executive 2026-08-01 article Part V Rules and Regulations D09002ee1e61a7f35 D09002ee1e61a8011 United States Department of Health and Human Services originator org United States Government Agency or Subagency United States Centers for Medicare & Medicaid Services originator org United States Government Agency or Subagency This final rule updates the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2027. This final rule also includes an analysis of Medicare non-hospice spending, including details regarding a hospice service and spending variation index, and finalizes the requirement that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election. Additionally, this rule finalizes conforming changes to discharge from hospice care regulations and changes to the face-to-face encounter regulations. This final rule also includes a summary of comments received on our requests for information regarding community- based palliative care; the construction of a hospice specific wage index; and the overlap between hospice and medical aid in dying laws. Finally, this rule finalizes changes to the Hospice Quality Reporting Program. 91 FR 49118 https://www.govinfo.gov/app/details/FR-2026-08-03/2026-15686 2026-15686 fr03au26-10 RIN 0938-AV78 4169-69-P CMS-1851-F https://www.govinfo.gov/app/details/FR-2026-08-03/2026-15686 https://www.govinfo.gov/content/pkg/FR-2026-08-03/html/2026-15686.htm https://www.govinfo.gov/content/pkg/FR-2026-08-03/pdf/2026-15686.pdf Health Facilities Hospice Care Medicare Reporting and Recordkeeping Requirements 59 p. 49118 49176 91 FR 49118 Title 42 Part 418 42 CFR Part 418 RIN 0938-AV78 Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements; Federal Register Vol. 91, Issue RULE 2026-15686 V DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 2026-10-01 CMS-1851-F 4169-69-P 2026-15686 Final rule.

This final rule updates the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2027. This final rule also includes an analysis of Medicare non-hospice spending, including details regarding a hospice service and spending variation index, and finalizes the requirement that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election. Additionally, this rule finalizes conforming changes to discharge from hospice care regulations and changes to the face-to-face encounter regulations. This final rule also includes a summary of comments received on our requests for information regarding community- based palliative care; the construction of a hospice specific wage index; and the overlap between hospice and medical aid in dying laws. Finally, this rule finalizes changes to the Hospice Quality Reporting Program.

These regulations are effective on October 1, 2026. For general questions about hospice payment policy, send your inquiry via email to: hospicepolicy@cms.hhs.gov. Health Facilities Hospice Care Medicare Reporting and Recordkeeping Requirements Medicare Program Fiscal Year 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements, hospicepolicy@cms.hhs.gov https://oig.hhs.gov/documents/audit/10055/A-09-23-03024.pdf https://oig.hhs.gov/documents/audit/9604/A-09-20-03015-Complete%20Report.pdf https://oig.hhs.gov/documents/audit/9609/A-09-20-03026-Complete%20Report.pdf https://www.bls.gov/ https://www.bls.gov/oes/ https://www.bls.gov/oes/current/oes_tec.htm https://www.bls.gov/oes/special-requests/oesm24in4.zip https://www.bls.gov/oes/tables.htm https://www.bls.gov/productivity/notices/2021/mfp-to-tfp-term-change.htm https://www.cms.gov/data-research/statistics-trends-and-reports/medicare-program-rates-statistics/market-basket-research-and-information https://www.cms.gov/files/document/addendum-c-cms-1805-p-esrd-pps-proposed-wage-index-construction-methodology.pdf https://www.cms.gov/files/document/fall-2024-hqrp-tep-summary-report508c.pdf https://www.cms.gov/files/document/hh-hospice-moratorium-faqs.pdf https://www.cms.gov/hospice-information-center https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/hospice-center https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/Hospice/Downloads/2016-11-15-Part-D-Hospice-Guidance.pdf https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice/hospice-regulations-and-notices https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice/hospice-wage-index https://www.cms.gov/medicare/payment/prospective-payment-systems/hospice/hospice-educational-resources https://www.cms.gov/medicare/quality/hospice https://www.cms.gov/medicare/quality/hospice/hqrp-extensions-and-exemption-requests https://www.cms.gov/medicare/quality/hospice/hqrp-reconsideration-requests https://www.cms.gov/medicare/quality/hospice/hqrp-requirements-and-best-practices https://www.cms.gov/medicare/quality/hospice/hqrp-training-and-education-library https://www.cms.gov/medicare/quality/hospice/provider-and-stakeholder-engagement https://www.cms.gov/medicare/quality/meaningful-measures-initiative https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c11.pdf https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicareprogramratesstats/downloads/tfp_methodology.pdf https://www.hhs.gov/conscience/your-protections-against-discrimination-based-on-conscience-and-religion/index.html https://www.hospicecahpssurvey.org/ https://www.hospicecahpssurvey.org/en/participation-exemption-for-size/ https://www.medicare.gov/care-compare/ https://www.medpac.gov/wp-content/uploads/2022/07/Wage-index-March-2023-SEC.pdf https://www.ncbi.nlm.nih.gov/books/NBK190070/ https://www.sba.gov/sites/sbagov/files/2023-03/Table%20of%20Size%20Standards_Effective%20March%2017%2C%202023%20%281%29%20%281%29_0.pdf https://www.whitehouse.gov/wp-content/uploads/2023/07/OMB-Bulletin-23-01.pdf https://www.whitehouse.gov/wp-content/uploads/2025/08/CircularA-4.pdf Medicare.gov Vol. 91, no. 147 Office of the Federal Register, National Archives and Records Administration 2026-08-03 continuing daily deposited born digital 519 p. Table of Contents: AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-2026-08-03 P0b002ee1e61a5b18 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:fr03au26 https://www.govinfo.gov/app/details/FR-2026-08-03 https://www.govinfo.gov/content/pkg/FR-2026-08-03/pdf/FR-2026-08-03.pdf https://www.govinfo.gov/content/pkg/FR-2026-08-03/xml/FR-2026-08-03.xml fdlp 48755 49267 DGPO 2026-08-01 2026-08-01 FR-2026-08-03 machine generated eng FR FR-2026-08-03 91 147