Palmetto GBA Hospice Rate Calculator
Estimate Medicare Hospice Reimbursement for Jurisdiction J & M
Routine Home Care (Days 1-60)
Routine Home Care (Days 61+)
Continuous Home Care (Per Hour)
Inpatient Respite Care
General Inpatient Care
Use hours for CHC, days for others.
Estimated Reimbursement
Daily/Hourly Adjusted Rate:
$0.00
Total Estimated Payment:
$0.00
Understanding Palmetto GBA Hospice Rates
Palmetto GBA serves as the Medicare Administrative Contractor (MAC) for specific jurisdictions. Hospice reimbursement is determined by the Medicare federal base rates, which are adjusted annually and modified by the geographic wage index associated with the patient's location (CBSA).
How the Calculation Works
The calculation follows the standard CMS formula for hospice payment:
- Labor Portion: (Base Rate × Labor Share %) × Wage Index
- Non-Labor Portion: Base Rate × (1 – Labor Share %)
- Total Adjusted Rate: Labor Portion + Non-Labor Portion
Key Rate Components (FY 2025 Estimates)
| Level of Care | Base Rate | Labor Share |
|---|---|---|
| Routine Home Care (1-60) | $225.23 | 68.1% |
| Routine Home Care (61+) | $177.76 | 68.1% |
| General Inpatient (GIP) | $1,168.16 | 68.1% |
| Continuous Care (Full Day) | $1,578.43 | 68.1% |
| Inpatient Respite (IRC) | $531.02 | 54.1% |
Example Calculation
If a provider in a region with a Wage Index of 1.0500 provides 5 days of Routine Home Care (Days 1-60):
- Base Rate: $225.23
- Labor Portion (68.1%): $153.38 × 1.0500 = $161.05
- Non-Labor Portion (31.9%): $71.85
- Daily Adjusted Rate: $161.05 + $71.85 = $232.90
- Total Payment: $232.90 × 5 = $1,164.50