Medicare's daily hospice payment covers most of the cost, but the amount varies by location and the level of care needed

Medicare pays hospice providers a set amount per day for each patient, rather than billing for individual services. The daily rate depends on where you live, what type of care is being delivered, and which hospice provider you use. In 2024, the base daily rates range from roughly $180 to $215 per day, though your specific hospice will receive an adjusted amount based on geographic factors and the wage index in your area. This payment covers nursing, aide services, medications related to the terminal illness, equipment, and counseling — not separate bills for each visit.

You do not pay this daily rate directly. Medicare sends the payment to the hospice agency, and you are responsible only for a small copay on certain medications and medical equipment, capped at 5 percent of the Medicare-approved amount. If you have supplemental insurance or Medicaid, those programs may cover your copays.

Key Takeaways

  • Medicare pays hospice providers a daily rate that varies by location, ranging from approximately $180 to $215 per day in 2024, adjusted for your region.
  • The daily payment covers nursing, aides, medications for the terminal condition, equipment, and counseling — you do not receive separate bills for each service.
  • You pay only a copay of up to 5 percent on certain medications and durable medical equipment, not the full daily rate.
  • The hospice agency bills Medicare directly; the payment does not come out of your Medicare benefits or count toward your deductible.

How the daily payment is calculated and adjusted

The Centers for Medicare & Medicaid Services (CMS) sets a base daily rate each year, then adjusts it for your state and county using a geographic adjustment factor. This factor accounts for differences in labor costs and living expenses across regions. A hospice in a rural area of Mississippi will receive a different daily rate than one in suburban Massachusetts, even though both are paid by Medicare.

The hospice provider you choose does not affect the daily rate — Medicare pays the same amount whether you go to a large national chain or a small local nonprofit. The rate is the same whether you receive care at home, in a nursing facility, or in an inpatient hospice unit. What changes is the intensity of services: if you need continuous nursing care (for example, during a crisis at home), Medicare may pay a higher daily rate for that specific day, but the base rate remains the same.

What the daily payment includes

The Medicare daily rate covers all routine hospice services related to your terminal illness and comfort. This includes visits from registered nurses and licensed practical nurses, home health aides, social workers, chaplains or counselors, and volunteers. It also covers medications prescribed for pain, nausea, breathing difficulty, and other symptoms of your condition — not medications for unrelated illnesses.

Medical equipment and supplies are included: hospital beds, wheelchairs, oxygen, wound care supplies, and other items your hospice team orders. Bereavement counseling for your family for up to 13 months after your death is also covered. The only costs you may owe are the copays on certain drugs and equipment, which are capped at 5 percent of the Medicare-approved amount per item.

When Medicare pays a higher daily rate

Most days, Medicare pays the standard daily rate. However, on days when you need continuous nursing care — meaning a nurse is present for at least 8 hours in a 24-hour period — Medicare pays a higher rate for that day. This might happen during a medical crisis, severe pain that requires frequent adjustment, or rapid decline. The hospice team decides when continuous care is medically necessary.

If you are in an inpatient hospice facility or hospital bed under hospice care, the daily rate is also higher than home-based care. These rates reflect the additional overhead of running a facility. Once you return home, the rate drops back to the standard amount.

What is not covered by the daily payment

Medications and treatments for conditions unrelated to your terminal illness are not covered by the hospice daily rate. For example, if you are on hospice for advanced cancer but also have diabetes, insulin is not included — that would be billed to your regular Medicare Part B. Similarly, if you need hospitalization for an acute injury or infection unrelated to your hospice diagnosis, that hospital stay is billed separately to Medicare Part A.

Room and board at a nursing home or assisted living facility is also not covered by the hospice daily rate, though the hospice services you receive while living there are covered. If you live in a nursing home and receive hospice, Medicare pays the hospice rate to the hospice agency and a separate rate to the nursing home for room and board.

How the payment works if you have other insurance

If you have both Medicare and Medicaid, Medicaid may cover your copays and any costs Medicare does not cover. If you have a Medigap (supplemental) policy, it typically covers the copays you would owe. Check with your supplemental insurance to confirm what hospice costs they cover.

If you have private insurance through a former employer or marketplace plan, that insurance does not usually pay for hospice once you are on Medicare. Medicare becomes your primary payer for hospice services. However, your private plan may still cover medications or treatments for unrelated conditions.

Understanding the difference between daily rates and your out-of-pocket cost

The daily rate Medicare pays is not the same as what you pay. Medicare sends the full daily rate to the hospice agency. You are responsible only for copays on certain medications and equipment — typically 5 percent of the approved amount, with a maximum copay per item. Many people pay nothing out of pocket because their supplemental insurance or Medicaid covers these small copays.

The daily rate also does not reduce your Medicare benefits or count toward your Part A deductible. Hospice is covered separately, and using hospice does not limit your access to other Medicare services for unrelated conditions. If you leave hospice and return to curative treatment, your regular Medicare coverage resumes without penalty.

Frequently Asked Questions

Does the daily rate change if I switch hospice agencies?

No. Medicare pays the same daily rate regardless of which hospice you choose. The rate is set by your location and the type of care, not by the provider. You can change hospice agencies at any time without affecting the payment amount.

What happens if hospice costs more than Medicare pays per day?

Hospice agencies are required to accept Medicare's daily rate as payment in full. They cannot bill you for the difference between what Medicare pays and their actual costs. If a hospice tries to bill you for uncovered services, contact your state's hospice ombudsman or Medicare at 1-800-MEDICARE.

Does the daily payment stop if I am hospitalized while on hospice?

If you are hospitalized for an acute condition, the hospice daily payment stops during the hospital stay. The hospital bills Medicare Part A instead. When you return home or to the hospice facility, the daily payment resumes. Some hospices continue to provide services during a hospital stay at no extra charge, but Medicare does not pay them for those days.

Can I see the exact daily rate my hospice receives?

Yes. The CMS publishes the hospice payment rates by state and county each year on their website. You can also ask your hospice agency directly what daily rate Medicare is paying them for your care. They are required to provide this information.

Does the daily rate cover bereavement counseling after death?

Yes. Bereavement services for your family are included in the daily rate and continue for up to 13 months after your death at no cost to your family. This typically includes counseling, support groups, and educational materials.