2027 Hospice Final Rule: Key Changes Hospice Providers Need to Know

The 2027 Hospice Final Rule introduces several important updates that hospice providers should understand as they prepare for the year ahead. Taking effect October 1, 2026, the rule applies to fiscal year 2027, ending September 30, 2027. From reimbursement updates to new operational and compliance requirements, here’s a closer look at the key provisions and what they mean for hospice providers.

BASE PAYMENT RATE ADJUSTMENT

The 2027 Hospice Final Rule includes a 2.3% increase to the base payment rates across all levels of hospice care, including routine, continuous, inpatient, respite care, and general inpatient care (GIP). The hospice cap amount also received a 2.3% increase over the prior year’s amount.

CMS has also published the final FY 2027 Hospice Wage Index. In addition to reviewing the updated payment rates, hospice providers should review the 2027 Final Hospice Wage Index to understand the wage index applicable to their geographic area.

FACE-TO-FACE ENCOUNTERS

The telehealth provisions for Face-to-Face Encounters were finalized, with updated language extending the use of telehealth for these encounters through December 31, 2027.

For hospice Face-to-Face Encounters, the practitioner conducting the encounter must be enrolled in PECOS. When the encounter is performed via telehealth, the platform used must be HIPAA compliant, and the visit must include both audio and video components.

A new G-code, G0679, has also been released. While it was not included in the Final Rule, it is addressed in Transmittal R13860CP. Beginning January 1, 2027, hospices will use G0679 on claims to indicate that the Face-to-Face Encounter associated with the claim was conducted via telehealth. This G-code should not be reported when the Face-to-Face Encounter is conducted in person.

SSVI/ELECTION STATEMENT ADDENDUM

The SSVI data was also finalized as a tool that will be used moving forward to assess and score individual hospice agencies based on the scoring outlined in the proposed rule. The scoring focuses on live discharge rates and the volume of non-hospice Medicare spending, with particular attention to spending under Medicare Part B and Part D.

As a result of concerns identified through SSVI data and other data reviewed over the past several years, hospices will be required to provide the Election Statement Addendum to 100% of new admissions beginning October 1, 2026. Previously provided to patients upon request, the addendum will now be required for all patients and must be provided within the five-day comprehensive assessment window.

If there is a change that affects the information included in the Election Statement Addendum, the addendum must be updated and provided to the patient within three days of identifying the change. This new requirement means hospices will need processes in place not only to provide the addendum for every admission, but also to ensure it is updated when necessary. Additionally, the current Election Statement will need to be revised to state that the Election Statement Addendum will be provided, rather than indicating that the patient may request it.

We anticipate that CMS may issue a sample Election Statement reflecting this updated language. In the meantime, the key change is to remove the current language stating that the patient may request the addendum and replace it with language indicating that the addendum will be provided.

Hospices should exercise great care when completing the Election Statement Addendum. CMS emphasizes that items, services, and medications a patient needs while receiving hospice care should generally be provided by the hospice, with unrelated items or services limited to unusual and exceptional circumstances. We anticipate that CMS may provide examples of what could appropriately be identified as unrelated on the addendum, but that guidance has not yet been provided.

MEDICARE ENROLLMENT REQUIREMENTS

This Final Rule included a significant number of changes. While we have your attention, we also want to highlight the Home Health Proposed Rule, which is expected to be finalized in November and has an open comment period through August 31. It includes several proposed changes to Medicare enrollment requirements that could also impact hospice providers, so we encourage you to review those provisions closely.

The proposed Medicare enrollment changes could create significant challenges for both home health and hospice providers. If the Home Health Proposed Rule is finalized as written, agencies will need to carefully evaluate the impact of the new Medicare enrollment requirements and prepare accordingly.

If your hospice needs assistance analyzing the Final Rule or preparing for implementation, Healthcare Provider Solutions is here to help. Please don’t hesitate to reach out to us.

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