FY 2027 Hospice Payment Rate Update Proposed Rule Summary

On April 6, 2026, CMS published in the Federal Register (91 FR 17338) a proposed rule updating the Medicare hospice payment rates, wage index and Hospital Quality Reporting Program (HQRP) for FY 2027. This proposed rule also includes an analysis of Medicare non-hospice spending under a hospice election, including details regarding a hospice service and spending variation index that is intended to help CMS monitor utilization of hospices and signal potential program integrity risks. In addition, this rule also proposes that hospices provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election, rather than upon request. This proposed rule also includes requests for information on enhancing community palliative care services under current Medicare benefits; the development of a hospice-specific wage index using Bureau of Labor Statistics data; and information regarding the overlap between hospice and assisted suicide or “medical aid in dying.” With respect to the HQRP, CMS proposes to add an icon on the Medicare.gov Compare Tool to identify hospices that have failed to meet HQRP reporting requirements and also provides an update on the recently-implemented Hospice Outcomes and Patient Evaluation assessment tool.

CMS estimates that the overall impact of the proposed rule will be an increase of $785 million (2.4 percent) in Medicare payments to hospices during FY 2027.  CMS notes that wage index addenda for FY 2027 (October 1, 2026, through September 30, 2027) will be available only through the internet at https://www.cms.gov/files/zip/fy-2027-proposed-hospice-wage-index.zip.

Comments on the proposed rule are due by June 1, 2026.