Hospice FY2027 Payment Rates and Cap Updated — Implement by October 5
CMS Transmittal R13924CP (CR 14557) updates Hospice payment rates, wage index, cap, and Pricer effective October 5, 2026 for FY2027.
Action required by
October 5, 2026
Review the Action Required section below and ensure your team has completed all compliance steps before this date.
CMS Transmittal R13924CP, Change Request (CR) 14557, updates Hospice payment rates, the Hospice aggregate cap, the Hospice wage index, and the Hospice Pricer for Fiscal Year (FY) 2027 under Medicare Claims Processing Manual Publication 100-04. This is a fee schedule transmittal — not a proposed rule — and carries an implementation date of October 5, 2026. Any hospice claim for services on or after October 5, 2026 processed through shared systems must reflect the FY2027 rate tables, wage index values, and updated Pricer logic.
Regulatory Background
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Quick answers
Does the October 5, 2026 implementation date for CR 14557 apply to the date of service, the date of claim submission, or the date of claim processing?
Per standard CMS transmittal implementation conventions, CR 14557 applies to claims processed on or after October 5, 2026. Hospice claims for dates of service before October 5, 2026 that are still in process should price under FY2026 rates; claims processed on or after October 5, 2026 for services on or after that date will be auto-priced using the FY2027 Hospice Pricer. Confirm this interpretation with your MAC if claims span the implementation date boundary.
Which MLN resource should our billing team reference to obtain the actual FY2027 per-diem dollar amounts, since Transmittal R13924CP does not enumerate them?
Transmittal R13924CP directly references MLN Matters Article MM14557, released August 18, 2026, as the provider education companion document. MM14557 is the appropriate resource for the specific FY2027 RHC, CHC, GIP, and IRC per-diem rates, the updated aggregate cap dollar amount, and wage index tables needed to update internal billing systems before the October 5, 2026 go-live.
If our hospice's CBSA or wage index assignment changed for FY2027, will the Pricer automatically apply the correct wage index, or do we need to update our system manually?
The MAC-side Hospice Pricer updated under CR 14557 will automatically apply the FY2027 wage index for adjudication purposes. However, any internal billing software, contract management system, or revenue projection tool that independently calculates expected per-diem payments using a locally stored wage index table must be updated manually to the FY2027 CBSA values before October 5, 2026 to avoid internal reconciliation discrepancies.
Content summarized from publicly available federal publications including CMS, MAC contractors, and the Federal Register. CLV Intelligence is not affiliated with or endorsed by any government agency. This is not legal or medical advice.