Hospice Medicaid rates in Utah follow a clear pattern: slightly below the median for everyday care, above it for everything else. Utah Medicaid pays $183.64 a day for hospice routine home care on code T2042, which ranks 13th of 21 states and sits 1.6% below the $186.66 national median. On the three higher-acuity levels, Utah ranks between 5th and 6th in the country.
Utah is also one of the cleanest hospice schedules to read. All four levels of care use the standard HCPCS hospice codes, T2042 through T2045, all carry the same effective date of 2026-10-01, and none has a prior authorization rule attached.
Utah Medicaid hospice reimbursement by level of care
| Level of care | Code | Utah rate | Rank | vs national median |
|---|---|---|---|---|
| Routine home care | T2042 | $183.64 a day | 13 of 21 | -1.6% |
| Continuous home care | T2043 | $69.37 an hour | 6 of 16 | +4.9% |
| Inpatient respite | T2044 | $557.97 a day | 5 of 19 | +5.2% |
| General inpatient care | T2045 | $1,194.29 a day | 6 of 18 | +3.1% |
Rates are paid under Utah Medicaid (fee-for-service, Traditional plan). For a Utah hospice, the message is that the high-acuity days pay well and the ordinary days pay about what they pay elsewhere.
Inpatient respite: Utah's strongest rank
Inpatient respite is a short inpatient stay that gives family caregivers a break. Utah's $557.97 a day is the fifth-highest respite rate in the country. Only Oregon ($629.83), New Jersey ($585.40), New York ($571.19) and Massachusetts ($560.76) pay more.
At the other end, Kansas pays $496.74, Missouri $492.74 and Arkansas $212.93. The national median is $530.15.
For a hospice that serves patients cared for mostly by family, respite is a real part of the care plan, and Utah pays it at a top-five rate.
Routine home care, continuous care and general inpatient
Routine home care. At $183.64 a day, Utah sits in the middle of the pack: above Missouri ($178.98), South Carolina ($173.92) and Arkansas ($80.36), and below the New England states and New York, which leads at $317.60. The 1.6% gap to the median is small, but routine home care covers most hospice patient days, so it is the rate that carries a census.
Continuous home care. Utah's $69.37 an hour ranks 6th of 16. Oregon leads at $80.47, followed by Washington ($77.54), New Hampshire ($74.56) and South Dakota ($71.92); West Virginia is lowest at $59.29.
General inpatient care. At $1,194.29 a day, Utah ranks 6th of 18, behind Oregon ($1,354.60), New York ($1,299.97), New Jersey ($1,253.17), South Dakota ($1,231.51) and Massachusetts ($1,202.36), and well above the median of $1,157.99.
Nurse and social worker wages in Utah
Federal occupational wage data for May 2025 shows a mixed labor picture:
- Registered nurse: $40.67 in Utah, against a US median of $46.90.
- Home health / personal care aide: $17.25, against $17.21.
- Healthcare social worker: $37.57, against $32.63.
- Chaplain: the US median is $29.24; no Utah median is published.
Two points stand out. Registered nurses earn well below the US median, while Utah's nursing-heavy rates, continuous home care and general inpatient care, are above their medians. At $69.37 an hour against a $40.67 median nurse wage, continuous care has more room in Utah than in many states. Social workers, by contrast, cost more than the national norm, and aides cost almost exactly the national median.
On routine home care, where the daily rate is slightly below median, the visit mix decides the margin. A hospice that leans on aide and nurse visits benefits from Utah's wage profile; one that leans heavily on social work feels the higher wage.
Coverage rules and prior authorization
Utah lists no prior authorization rules for any of its hospice codes: T2042, T2043, T2044 and T2045, nor for G0155. Hospice eligibility still requires the usual certification and election, but Utah does not add a separate prior authorization step to its hospice rates.
Utah has updated its hospice policy through a series of MIB notices:
- MIB May 2025 25-31: Hospice Care Services Provider Manual Update and Policy Clarification, effective 2025-05-01.
- MIB March 2023 23-15: Hospice Provider Manual Updated, effective 2023-03-01.
- MIB March 2023 23-09: PRISM Information MIBs, effective 2023-03-01.
- MIB September 2022 22-90: Hospice Services Updates, effective 2022-09-01.
These are manual and policy updates rather than rate changes, but they set the billing and documentation rules a Utah hospice must follow. The May 2025 clarification is the most recent and the one to read first.
Managed care and Utah hospice
Our data names 27 plans in Utah Medicaid, including medical plans such as Health Choice Utah, Healthy U and Healthy Outcomes Medical Excellence (HOME). Utah's managed-care rules do not classify a separate hospice line. Neighboring lines show the range: nursing facilities and home and community-based services are paid directly by the state, outside managed care, while home health is negotiated by plans, with the published rate applying out of network.
A hospice contracting with Utah plans should confirm in each contract whether the fee-for-service rate is the floor. The Utah managed-care page shows the rule for each line.
Utah in the national picture
Utah is a strong-but-not-top payer: top six on every inpatient and crisis level, just under the median on routine care, on standard codes with no prior authorization. Compare it with every state on the hospice industry hub, see all Utah codes on the Utah Medicaid rates page, and read our methodology for how hospice rates are ranked. Every rate is compiled from official state Medicaid publications and links to its source document.
Updated 2026-10-05