Hospice end-of-life visit add-on (per hour): Medicaid rates by state

States publish hospice end-of-life visit add-on (per hour) under their own codes, modifiers and units. To compare them, this page picks the rate in each state that matches the same service and provider level.

• Provider level. States are compared at the registered nurse (RN) level. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
• Unit. Of the 14 states, 10 publish their headline rate per 15 min, 3 per hour and 1 per hour/max. The ranking converts every time-based rate to an hour of service, so states that bill by the 15 minutes and by the hour compare directly.
• Variants. 14 of the 14 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
• Depth. 12,857 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.

The highest-paying state, New Jersey, pays $291.56 per hour; the lowest, Arkansas, pays $54.10 per hour, a 5.4x gap. 7 of the 14 states pay above the median of $66.96 per hour. Common reasons rates for hospice services spread this way:

• Medicaid hospice rates are generally set using the Medicare hospice methodology and adjusted by a wage index, so the differences between states mostly reflect local wage levels.
• Service-intensity add-ons and the split between the first days of care and later days change the daily amount.

Billing notes

Hospice is paid per day at one of four levels of care: routine home care, continuous home care (paid by the hour), inpatient respite and general inpatient care.