Federal FY2026 Revised Hospice Rates and County Wage Index Values
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Provides Federal FY2026 hospice payment rate calculations (effective 10/01/25–09/30/26) including wage index values for all Illinois counties and the components used to compute daily, hourly, and quarter‑hour rates. Affects hospice billing and reimbursement determinations for providers billing Illinois Medicaid.
No material clinical or coverage changes in this revision.
Rate Calculation Methods and Coverage Criteria
Routine Home Care calculation
Method for computing payment amounts for Routine Home Care by revenue code using the CBSA wage index and the listed components.
ALL of the following
- Base Rate = CBSA Wage Index * Wage Component (use the wage component for the specific Routine Home Care period: Days 1–60 or Days 61+).
- Daily Rate = Base Rate + Non-weighted Amount (use the non-weighted amount corresponding to the same revenue code/period).
Wage and non-weighted component values provided in the document: 0651 Days 1-60 — Wage Component $152.55; Non-weighted Amount $78.58. 0651 Days 61+ — Wage Component $120.24; Non-weighted Amount $61.94.
Service Intensity Add-On calculation
Service intensity add-on payment computation.
Document-provided components for service intensity add-on: Wage Component = $52.48; Non-weighted Amount = $17.31.
Continuous Home Care calculation
Continuous home care payment computation.
Document-provided components for continuous home care (0652): Wage Component = $1,259.56; Non-weighted Amount = $415.38.
Inpatient Respite and General Inpatient calculation
Inpatient respite and general inpatient care computation.
Document-provided components: 0655 (Inpatient Respite) — Wage Component $341.91; Non-weighted Amount $218.60. 0656 (General Inpatient) — Wage Component $761.91; Non-weighted Amount $437.95.
Revenue Codes, Units, and Coding Details
| 0651 | Routine Home Care (Days 1-60 and Days 61+) |
| 055X/056X | Service Intensity Add-On |
| 0652 | Continuous Home Care |
| 0655 | Inpatient Respite Care |
| 0656 | General Inpatient Care |
Required Provider Calculations and Billing Actions
Calculate FFY2026 hospice rates using listed wage and non‑weighted components
For dates of service in Federal Fiscal Year 2026 (10/01/25–09/30/26), use the revenue-code–specific wage component (labeled “1”) and non‑weighted amount (labeled “2”) listed in the rate table to compute Base and Daily/Hourly/Quarter‑Hour rates per the calculation rules in this document.
- 0651 Routine Home Care (Days 1-60): Wage component (1) = $152.55; Non‑weighted amount (2) = $78.58.
- 0651 Routine Home Care (Days 61+): Wage component (1) = $120.24; Non‑weighted amount (2) = $61.94.
- 055X/056X Service Intensity Add‑On: Wage component (1) = $52.48; Non‑weighted amount (2) = $17.31.
- 0652 Continuous Home Care: Wage component (1) = $1,259.56; Non‑weighted amount (2) = $415.38.
- 0655 Inpatient Respite Care: Wage component (1) = $341.91; Non‑weighted amount (2) = $218.60.
- 0656 General Inpatient Care: Wage component (1) = $761.91; Non‑weighted amount (2) = $437.95.
Rate Calculation Definitions
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