Medicare’s payment to hospice providers for routine home care is $236.33 per day for the first 60 days of a patient’s care, starting October 1, 2026. The rate comes from a corrected fiscal year 2027 notice from the Centers for Medicare & Medicaid Services (CMS), and it is in effect, not proposed. The notice carries a 2.3 percent payment update for hospices that submit the required quality data.
Those figures set what Medicare pays hospice agencies, not what a patient is billed. For most beneficiaries the hospice benefit itself costs little, and the difference between the two matters for families weighing end-of-life care this fall.
What the correction notice sets for each level of care
The notice, published in the Federal Register on September 30 as document 2026-20067 (91 FR 61791), is labeled “Final rule; correction.” It states plainly: “This correction is effective October 1, 2026.” The document was signed by Liesl I. Fowler, Executive Secretary to the Department of Health and Human Services, on behalf of CMS.
The corrected FY 2027 per-diem rates in the notice are:
- Routine home care, days 1 through 60: $236.33 per day
- Routine home care, day 61 and later: $186.33 per day
- Continuous home care: $1,726.16 per 24 hours, or $71.92 per hour
- Inpatient respite care: $545.93 per day
- General inpatient care: $1,231.51 per day
Routine home care is the everyday level of hospice, delivered wherever the patient lives. The rate drops by $50 after day 60, from $236.33 to $186.33, so a patient who stays on hospice for months generates a lower daily payment for the agency after the two-month mark. Continuous home care is the most heavily paid home-based level, set at $1,726.16 for a full 24 hours.
Why a correction was needed at all
CMS finalized its FY 2027 hospice rates in a rule dated August 3, 2026. The correction exists because one hospital, identified in the notice by CMS Certification Number 250078, was inadvertently treated as having converted to rural emergency hospital status. That error fed into the hospice wage index, so CMS had to recalculate wage indexes and the payment rates built on them. The five rates above are the recalculated ones. CMS lists Chantelle Caldwell at (410) 786-8743 for wage index questions, and general inquiries go to hospicepolicy@cms.hhs.gov.
The 2.3 percent update is not automatic for every provider. The notice applies it to hospices that submit the required quality reporting data. A hospice that does not report takes a negative 1.7 percent adjustment instead, a gap of four percentage points between agencies that comply and those that do not. For a family choosing among local hospices, quality reporting status is one of the few standardized signals of an agency’s compliance with federal requirements.
What a hospice patient pays under Medicare
The per-diem rates are payments to the hospice, and they do not create a new bill. According to Medicare’s hospice coverage page, “You pay nothing for hospice care if you get your care from a Medicare-approved hospice provider.” Patient cost-sharing is limited to a few specific items:
- Prescriptions: a copayment of up to $5 for each outpatient prescription used for pain and symptom management.
- Inpatient respite care: coinsurance of 5 percent of the Medicare-approved amount for short-term care that gives caregivers a rest, with the total capped at the inpatient deductible amount.
- Room and board: a patient who lives in a facility such as a nursing home and chooses hospice there may have to pay for room and board.
As arithmetic only, 5 percent of the $545.93 respite rate is about $27 a day, though the amount a patient owes depends on the Medicare-approved amount for the specific agency and area, which the wage index adjusts. The notice itself does not address patient coinsurance, so the cost-sharing rules above come from the Medicare program’s own description, not from the correction.
Eligibility is unchanged by the notice. Medicare’s page says the hospice doctor and the patient’s regular doctor, if there is one, must certify a life expectancy of six months or less, and the hospice medical director recertifies after a face-to-face meeting once the first period ends.
Where the daily rate shows up for families
A higher or lower federal rate is felt mostly through the hospice’s capacity and choices, since the agency, not the patient, receives the payment. Families comparing providers can ask whether the hospice reports quality data, which level of care a loved one is being billed under, and which drugs and equipment the plan of care covers. Charges that fall outside the narrow cost-sharing list above, such as an unexpected bill for a medication the hospice says is unrelated to the terminal diagnosis, are worth questioning directly with the agency.
The controlling record for every figure here is the Federal Register correction notice itself. CMS issued no companion news release, so the Fowler-signed notice, with Caldwell named as CMS’s contact for wage index questions, is the authoritative statement of the rates in effect from October 1.
Hospice coverage and the Medicare costs that surround it
The Medicare Cost & Coverage Protection Kit is written for people on Medicare, and for family members helping them, who are juggling prescription costs, state help programs and coverage denials. It addresses the practical problem of keeping those costs and appeals in one place.
The Medicare Cost & Coverage Protection Kit is a 10-page kit with 51 state Medicare cost-help packs, the prior-authorization appeal steps and a medication and cost tracker for recording what each prescription and service costs.
Tap here to line up Medicare drug and care costs in one tracker →
This article was produced with AI assistance and checked against the primary sources linked above.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
