Hospice Medicaid Rates in Rhode Island (2026)

Hospice Medicaid rates in Rhode Island are among the highest in the country for the level of care that matters most. Rhode Island Medicaid pays $222.38 a day for hospice routine home care on code T2042, effective 2026-10-01. That ranks 4th of 21 states with a comparable daily rate and sits 19.1% above the $186.66 national median.

What makes Rhode Island unusual is not the rank alone but how much rate activity surrounds it: a rate freeze proposal, a provider update announcing a hospice rate increase, a CMS-approved state plan amendment, and a proposed rate review listing a further 9.2% change. For a hospice operating in the state, routine home care is both well paid and moving. This page explains the rate, the wage market behind it, how plans pay, and how to plan around a schedule that changes often.

Routine home care is billed per day for every day a patient is enrolled and at home, regardless of whether a visit occurs that day. At $222.38, Rhode Island's daily rate puts it in a tight cluster of states at the top of the national table:

Outside New York, which bills on its own code, the top five are separated by only a few dollars a day. Massachusetts and Maine sit just above Rhode Island, and New Jersey just below. The national median of $186.66 is well below all of them.

Because routine home care covers most hospice patient days, the gap to the median matters across a whole census. A Rhode Island hospice is paid more per day than most peers for the same intermittent nursing, aide, social work and chaplain visits, plus the drugs, equipment and supplies related to the terminal illness.

T2042 is the HCPCS code for routine home care, billed as one unit per day. The rate is the same whether the hospice team makes several visits that day or none.

That flat structure has two consequences. First, the cost of each day varies far more than its payment: the days after admission and before death are visit-heavy, while a stable patient in mid-stay may need few visits. Second, length of stay shapes margin. Very short stays concentrate the costly days, while longer stays include more lower-cost days. A Rhode Island hospice that tracks cost per day by stage of the stay understands its margin far better than one that only looks at the rate.

Routine home care is the only hospice level of care for which Rhode Island has a current comparable rate in our data. The other three levels are benchmarked nationally, and they show where a Rhode Island hospice would sit if it bills them:

• Continuous home care (T2043). The national median is $66.11 an hour across 31 states, ranging from $59.29 in West Virginia to $80.47 in Oregon.
• Inpatient respite (T2044). The national median is $530.15 a day; Oregon pays $629.83 and New Jersey $585.40.
• General inpatient care (T2045). The national median is $1,157.99 a day, with Oregon at $1,354.60 and New York at $1,299.97.

Rhode Island's strong position on routine home care does not guarantee the same standing on these levels. Hospices that provide crisis care at home or contract for inpatient beds should check the state's source document for each level before building a budget around it.

Rhode Island's wage picture is the other half of the story. Federal occupational wage data for May 2025 shows:

Aides are the standout. At a $21.00 median against a $17.21 US median, Rhode Island hospice aides cost noticeably more than the national norm, and registered nurses and social workers also earn above the US median. Only chaplains come in slightly below.

The practical reading is that Rhode Island's above-median routine home care rate is offset in part by an above-median wage bill. A hospice whose visit mix leans heavily on aide hours will feel that most. In a small state with short travel distances, routing can work in a provider's favor: more visits per staff day lower the cost of each routine day without any change in the rate.

Rhode Island has one of the busier hospice rate histories in our data:

• RI hospice T2042 routine home care rates, effective 2023-07-01, with a 2.29% change.
• Hospice and Home Health rates (SFY2025 freeze), a state plan amendment proposed 2025-06-30 with an effective date of 2025-07-01.
• CMS approved RI SPA 25-0012, published 2026-08-31 and effective 2025-07-01.
• Provider Update 394: Attention Hospice Providers: Rate Increase, published 2025-11-01.
• OHIC Rate Review Updates covering EPSDT, Early Intervention, Home Health, Hospice and Targeted Case Management, published as a public notice on 2026-09-01 with an effective date of 2026-10-01. The proposed amendment lists a 9.2% change.

What the sequence means

Taken together, these show a state that has frozen, raised and reviewed hospice rates within a short period, with a further proposed change in the pipeline. A hospice that sets its budget on last year's rate risks misstating revenue in either direction. Check the effective date on each rate before billing, since retroactive approvals such as SPA 25-0012, approved more than a year after its effective date, can change what was owed for past dates of service.

The proposed amendment ties hospice to a rate review run alongside the Office of the Health Insurance Commissioner (OHIC), covering hospice together with home health, Early Intervention, EPSDT and targeted case management. Grouping these services suggests the state is reviewing community-based rates as a set rather than one line at a time.

For a hospice, three things are worth watching: whether the 9.2% change is approved as proposed, whether its effective date holds at 2026-10-01 or is applied retroactively later, and whether plans adjust their contracted rates when it takes effect. Until approval, treat the change as a scenario, not a budget line.

Rhode Island lists no prior authorization rule for code T2042 in its published hospice rules. Hospice eligibility still follows the usual certification and election requirements, but the daily routine home care rate itself is not subject to a separate prior authorization step in the state's coverage rules. That keeps admissions simple: once a patient elects hospice and is certified, routine days can be billed without a further approval.

Our data names 12 plans in Rhode Island Medicaid, including Neighborhood Health Plan of Rhode Island, Tufts Health Public Plans and UnitedHealthcare Community Plan of Rhode Island. For hospice, the state's rule is that plans negotiate their own rates, and the published rate applies out of network.

That is a different rule from neighbouring lines. For home health and personal care, plans must pay at least the published rate, while nursing facilities and home and community-based services are paid directly by the state, outside managed care. A hospice that also runs home health therefore works under a floor on one line and open negotiation on the other.

In practice, the fee-for-service rate is the hospice's strongest reference point in plan talks: a plan offer below $222.38 pays less than an out-of-network claim would. Ask each plan whether its rates follow state updates such as the proposed OHIC change. The Rhode Island managed care page sets out the rules line by line.

At the bottom of the routine home care table, Missouri pays $178.98, South Carolina $173.92 and Arkansas $80.36. Rhode Island's $222.38 is far closer to the top, with New York's $317.60 the only rate meaningfully above it.

For a multi-state hospice, that makes Rhode Island one of the better-paying markets for routine care days, tempered by higher aide and nursing wages. It also sits in a region where the neighbouring states pay similar amounts, so a hospice operating across the Rhode Island and Massachusetts border sees little change in routine revenue per day. The larger differences between those markets lie in plan rules, wage levels and how often each state revises its schedule.

1. Budget on the current rate, model the proposal. Run one scenario at $222.38 and another with the proposed change, and switch once it is approved.
2. Keep claims open for retroactive changes. Approvals can land long after effective dates.
3. Negotiate plan contracts from the out-of-network rate.
4. Plan aide staffing carefully. Aide wages are the biggest cost pressure relative to the national norm.

Rates on this page are compiled from official state Medicaid publications, and each rate links to its source document. Sources include Rhode Island's T2042 routine home care rate publications, Provider Update 394, RI SPA 25-0012 and the OHIC rate review public notice.

These hospice rates are part of all 76,101 current Rhode Island Medicaid rates across 91 service categories. The national view is on the hospice industry hub, all Rhode Island codes are on the Rhode Island Medicaid rates page, our methodology explains how daily hospice rates are compared, and pricing covers access to the full dataset.