Hospice Medicaid rates in Michigan sit below the national median on three of four levels of care. Michigan Medicaid pays $180.60 a day for routine home care, 17th of 21 ranked states and 3.2% below the national median of $186.66. The exception is continuous home care, where Michigan's $69.10 an hour ranks 7th of 16 and runs 4.5% above the median.
That split is the defining feature of Michigan's hospice rates. The hourly crisis-care level pays better than typical, while the daily rates, including the routine home care rate that covers most hospice days, run below it. The gap widens as the level of care gets more intensive, reaching 8.0% below the median for general inpatient care.
| Level of care | Michigan rate | Rank | Vs national median |
|---|---|---|---|
| Routine home care (0651) | $180.60 a day | 17th of 21 | 3.2% below |
| Continuous home care (0652) | $69.10 an hour | 7th of 16 | 4.5% above |
| Inpatient respite (0655) | $500.06 a day | 16th of 19 | 5.7% below |
| General inpatient care (0656) | $1,065.15 a day | 15th of 18 | 8.0% below |
All four rates are effective October 1, 2025 and are billed on revenue codes. In many states the same levels are billed on code T2042, T2043, T2044 and T2045.
Michigan publishes its hospice rates by county, in a source titled MDHHS Hospice Rates by County, FY2026. The figures on this page are the statewide rates used for national comparison; the rate a hospice actually receives depends on where the patient lives.
County-based rates mean that location matters alongside the level of care. For a hospice that serves several counties, that has three consequences:
- Bill by location of care. The county where the patient receives care determines the rate, so addresses must be accurate on every claim.
- Budget by territory. A census concentrated in higher-rate counties produces more revenue per day than the same census elsewhere.
- Check rate tables every October. The county table is labeled by fiscal year, so load the new year's table for dates of service from October 1.
Routine home care is paid for every day a patient is enrolled and at home, so Michigan's $180.60 is the core of a hospice's Medicaid revenue in the state. At 17th of 21, Michigan sits in the lower group, above Missouri ($178.98), South Carolina ($173.92) and Arkansas ($80.36) but below the median.
The gap to the top is wide. New York pays $317.60 and Massachusetts $231.13, with Maine ($223.84), Rhode Island ($222.38) and New Jersey ($219.21) next. A Michigan hospice gets 3.2% less per patient-day than a median state, which across a full Medicaid census adds up over a year.
The daily rate has to fund the whole interdisciplinary team for that day plus drugs, equipment and supplies related to the terminal illness. With a below-median daily rate, a Michigan hospice's margin depends heavily on visit efficiency and length of stay.
Continuous home care pays hourly for periods of crisis when a patient needs predominantly nursing care to remain at home. Michigan pays $69.10 an hour, 7th of 16 ranked states. Above it are Oregon ($80.47), Washington ($77.54), New Hampshire ($74.56), South Dakota ($71.92) and Massachusetts ($70.00). At the bottom, Georgia ($62.08), Kansas ($60.00) and West Virginia ($59.29) trail.
For Michigan hospices, continuous care is the one level where the state pays above a typical state. Hospices with the nursing capacity to staff crisis hours capture that premium; those that cannot staff continuous care hours forgo it, and their Medicaid revenue rests entirely on the below-median daily rates.
Federal occupational wage data for May 2025 puts Michigan slightly below the national median for each hospice role:
- Registered nurse: $45.34 an hour in Michigan, against $46.90 nationally
- Home health / personal care aide: $16.83, against $17.21
- Healthcare social worker: $32.50, against $32.63
- Chaplain: $27.16, against $29.24
Michigan's wages track the nation closely, so its rate position translates almost directly into its margin position. On continuous home care, a 4.5% rate premium combined with a slightly below-median RN wage gives a Michigan hospice more of each hour than a median-state hospice keeps.
On the daily rates, the effect runs the other way. Wages only slightly below the median do little to offset routine home care and inpatient rates that sit 3.2% to 8.0% below. General inpatient care, at $1,065.15 a day, is the tightest: it covers round-the-clock inpatient care and pays 8.0% less than the median.
Many Michigan hospice patients live in nursing facilities. Michigan publishes MDHHS Hospice/Nursing Facility room and board rates, with the current set covering 10/1/26 - 9/30/27. When a nursing facility resident elects hospice, the hospice is paid a room and board amount for that resident and passes it to the facility, while the facility continues to provide housing and daily care.
For a hospice, room and board is a pass-through rather than revenue, but it still needs careful handling. The amount must match the current period's rate, payment to the facility should follow the hospice's receipt of funds as agreed in the contract, and both sides should reconcile monthly. An error in room and board can make a hospice appear to owe a facility money it never received, or the reverse.
Under Michigan's managed care rules, plans negotiate nursing facility rates, with the published rate applying out of network, so room and board for plan members may follow plan contract terms.
Michigan Medicaid includes the Michigan Medicaid Health Plans (Comprehensive Health Care Program) and MI Health Link, with 11 plans on record. For hospice, plans negotiate rates with providers, and the published Michigan Medicaid rate applies out of network.
The published rate is therefore the reference point in every plan negotiation, and because Michigan publishes rates by county, the relevant comparison is the county rate where the hospice's patients live rather than a single statewide figure. A Michigan hospice that contracts in network should compare each plan's negotiated routine home care rate with the $180.60 published figure; a hospice that stays out of network is paid the published rate. Plan contracts also differ on authorization, eligibility checks and payment timing, which can matter as much as price for a hospice with a large Medicaid census. Michigan's rule for home and community-based services is different, with the state setting the rate plans pay, so hospices that also offer waiver services deal with two contracting models. The Michigan managed care page lists the rules for other service lines.
Michigan's recent policy activity is mostly administrative rather than rate-driven:
- Proposed policy 2520-MICH. A new Medicaid Provider Manual chapter for the MI Coordinated Health (MICH) program, published for consultation December 23, 2025.
- L 24-42. Intent to submit renewal applications for the Section 1915(b) and 1915(c) MI Health Link waivers, effective January 1, 2025.
- MMP 23-06. Home Health Agency and Hospice update to the attending provider field on the institutional claim form, published December 29, 2022.
MMP 23-06 is the one that touches hospice claims directly: it changed how the attending provider is reported on institutional claims. The MICH proposal is the one to watch, because a new program chapter can change how members are enrolled and how hospice claims are routed.
Older guidance still shapes billing. L 16-24, a hospice billing clarification, and MSA 20-41, which set alternative staffing provisions and virtual supervisory visits for hospice during the COVID-19 response, were partly rescinded and partly continued by MMP 23-22, effective 2023-05-12. A hospice should confirm which supervisory visit rules remain in force before relying on virtual visits.
Two Michigan notices from late 2026 affect the workers hospices rely on. L 26-59 proposes a state plan amendment to raise Home Help individual caregiver rates by 7.41%, and L 26-60, published 2026-10-02, proposes a reimbursement rate update for private duty nursing. Home Help is Michigan's state plan personal care program and is paid directly by the state, outside managed care.
Neither notice changes hospice rates, but both raise what competing employers can pay aides and nurses. With Michigan aide wages at a $16.83 median, a 7.41% increase on the Home Help side can pull caregivers away from hospice aide roles unless hospices respond.
Wisconsin pays more for routine home care at $192.39 a day and slightly less for continuous home care at $66.83 an hour. For a hospice serving the Upper Peninsula and northern Wisconsin, that contrast matters: routine days are worth more on the Wisconsin side and crisis hours more on the Michigan side.
- Use county rates. Budget and bill from the county rate where care is delivered.
- Staff continuous care. Michigan's above-median hourly rate rewards hospices that can cover crisis hours.
- Price inpatient contracts carefully. Keep bed costs inside $1,065.15 and $500.06.
- Negotiate from the published rate. Compare plan offers with the out-of-network rate.
The full Michigan dataset holds all 57,306 current Michigan Medicaid rates, with history back to 2009.
Every rate here is compiled from official Michigan Department of Health and Human Services publications, including MDHHS Hospice Rates by County, FY2026, and links to its source document. Wages are federal occupational medians for May 2025. For every Michigan service line, see the Michigan Medicaid rates hub. The national hospice rates comparison covers every state, and our methodology explains how hospice rates are ranked.