Hospice & Home Health News 2026July17

FY2027 Hospice Wage Index Final Rule Heads to OMB.

On July 10, the FY2027 Hospice Wage Index Final Rule was received by the Office of Management and Budget. This is the last part of the rulemaking process before the final rule is published. We anticipate the final rule in the first few weeks of August. 

OIG Announces Project on Hospice Payments for Care Provided in Nursing Homes

On July 15, the Office of Inspector General (OIG) updated its current workplan to include a new project looking at fixed daily rates paid to Medicare hospices serving residents in nursing homes. Hospices are paid the routine home care rate, which includes personal care, for care in nursing homes but nursing homes are also required and paid to provide these services as well. OIG will look at how this payment system undermines the efficiency of Medicare payments and adds to the incentives that bad actors have to exploit the program. This review will determine Medicare payments for routine home care provided to hospice beneficiaries in nursing homes, estimate potential cost savings from reducing the payment to address the inefficiency in the payment structure, and examine practices of hospices with a high percentage of their beneficiaries in nursing homes. The Hospice CARE Act, legislation that LeadingAge is deeply involved in, includes consideration of differential payments for hospices serving patients in nursing homes and the Centers for Medicare and Medicaid Services (CMS), as part of the FY2027 Hospice Wage Index Rule, proposed a measure of utilization to track hospices with significant numbers of nursing home patients. 

CMS Seeks Physician Feedback on Community-Based Palliative Care.

On July 14, the Centers for Medicare and Medicaid Services (CMS) released the CY2027 Physician Fee Schedule Proposed Rule, which among other key policy changes, includes a request for information (RFI) on community-based palliative care. This is the third request for information on community-based palliative care CMS has issued this year, including one specific to end-state renal disease patients. CMS is requesting feedback on eligibility and care management services for seriously ill populations. Additionally, in other sections of the proposed rule CMS is explicitly reconsidering the future of the care management services that form the basis for payment adequacy for important between visit care (in addition to E/M services for outpatient or home visits). Care for the seriously ill involves interdisciplinary care teams and involves even greater coordination and between visit care than primary care services. CMS requests feedback on what service elements need to be included in care management for seriously ill beneficiaries vs other Medicare beneficiaries. CMS also seeks feedback on determining how best to report quality of care safeguards and how to protect against waste, fraud, and abuse with current and future community-based palliative care programs.

CMS Announces G-Code for Hospice Face-to-Face Services Starting January 2027.



On July 10, the Centers for Medicare and Medicaid Services issued a Change Request (CR 14495) along with a Medicare Learning Network article outlining the expectations for reporting when a hospice face-to-face visit is conducted via telehealth starting January 1, 2027. With the passage of the Consolidated Appropriations Act of 2026 new guardrails were established for the hospice face-to-face visit when using telehealth. As part of this, in the FY2027 Hospice Wage Index Proposed Rule, CMS requested feedback from the provider community on how to appropriately capture on hospice claims when a face-to-face was conducted using telehealth. CMS is proposing to implement a G-Code (G0679) to accompany claims and designate a telehealth, face-to-face visit. Hospice providers will be required to submit the new G0679 code with the physician services revenue code 0657. Hospices will be required to report the encounter in line-item detail with each service reported as a separately dated line under the appropriate revenue code for each discipline furnishing the service. CMS outlines in their change request instances when the code will be rejected: 1) if G0679 is on a Type of Bill (TOB) other than 81x or 82x 2) when the code is submitted with any other Rev Codes other than 0657 and 3) when the claim billed only billed the new G0679 with Rev Code 0657 and no other services are present. LeadingAge reached out to CMS for additional clarification billing specifications, particularly when nurse practitioners are conducting the face-to-face, as currently hospices cannot bill Rev Code 0657 if the NP is not the patient's attending. We will keep members informed regarding CMS's response. Providers should reach out to the billing and EHR vendors to confirm they are aware and planning for the changes effective January 1, 2027.