Hospice Rates FFY 2026
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Lists fiscal year 2026 hospice reimbursement rates by revenue code and CBSA/index effective October 1, 2025; applies to hospice providers billing Georgia Medicaid.
No material clinical or coverage changes in this revision.
CBSA-specific Rate Examples
Example CBSA-specific rate row
Rate table entries (examples):
ALL of the following
ALL of the following
- CBSA multiplier = 0.9504 (CBSA NAME FY 2026)
- INDEX = 10500
- CBSA value = 223.56
ALL of the following
- Revenue Code 651 — Home Care (Days 1-60) = 176.22
- Revenue Code 651 — Home Care (Days 61+) = 67.19
- Revenue Code 651 — SIA Hourly = 16.80
- Revenue Code 651 — SIA Quarter Hour = 67.19
- Revenue Code 652 — Continuous Care (Hourly) = 543.55
- Revenue Code 655 — Respite Care = 1162.07
- Revenue Code 656 — Inpatient Care = 1
ALL of the following
- cbsa_index = 1
- cbsa_multiplier = 0.9504
- INDEX = 10500
- CBSA_value = 223.56
- rates: {651_days_1_60: 176.22, 651_days_61_plus: 67.19, 651_SIA_hourly: 16.80, 651_SIA_qtr_hour: 67.19, 652_continuous_hourly: 543.55, 655_respite: 1162.07, 656_inpatient: 1}
Revenue Codes and Geographic Index
| 651 | Home Care (Days 1-60); Home Care (Days 61+); SIA hourly/quarter-hour |
| 652 | Continuous Care (Hourly) |
| 655 | Respite Care |
| 656 | Inpatient Care (indexed by CBSA number) |
Billing and Payment Instructions
Bill using the CBSA-specific FFY2026 hospice rates
Providers must bill using the CBSA-specific hospice rates listed for Federal Fiscal Year 2026, effective October 1, 2025. The table specifies per-CBSA INDEX and multiplier and the dollar amounts to use for each revenue code (651 — Home Care: Days 1–60, Days 61+, SIA hourly/quarter-hour; 652 — Continuous Care hourly; 655 — Respite; 656 — Inpatient).
- Effective date: 10-01-2025 (rates apply on/after this date).
- Use the CBSA-specific dollar amounts shown for each revenue code when submitting claims (examples in the table: CBSA 1 — Home Care Days 1–60: $176.22; Continuous Care (Hourly) 652: $543.55; Respite 655: $1,162.07).
- CBSA rows include CBSA NAME FY 2026 multiplier, INDEX, CBSA value, and per-revenue-code rates to derive payment.
Revenue Code Definitions and Index Terms
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