Hospice Medicaid rates in Idaho were reset on 2026-10-01. Idaho Medicaid now pays $181.75 a day for routine home care on revenue code 0651, which ranks 16th of 21 ranked states and is 2.6% below the national median of $186.66.
Three things set Idaho apart from most hospice states. It pays continuous home care in 15 min units rather than by the hour. Its coverage rules put a prior authorization rule on routine home care and an election-period limit on respite. And its rates have just turned over under a new notice, MA26-21 Hospice Rates SFY 2027, so an Idaho hospice is working with a schedule that is days old.
All four Idaho hospice levels of care share the 2026-10-01 effective date. Idaho bills on revenue codes that correspond to the national codes T2042, T2043, T2044 and T2045.
| Level of care | Idaho rate | Rank | vs national median |
|---|---|---|---|
| Routine home care (0651) | $181.75 a day | 16 of 21 | -2.6% |
| Continuous home care (0652) | $16.22 per 15 min ($64.88 an hour) | 12 of 16 | -1.9% |
| Inpatient respite (0655) | $499.22 a day | not ranked | national median $530.15 |
| General inpatient care (0656) | $1,122.07 a day | not ranked | national median $1,157.99 |
The two ranked levels both sit in the lower half of states, a little under the national median. The two inpatient levels are not part of the national ranking, but both Idaho rates are below their national medians.
Routine home care covers most hospice patient days. It is billed for every day a patient is enrolled and at home, whether or not a visit occurs. Idaho's $181.75 is 2.6% below the $186.66 median and 16th of 21, which puts Idaho in the lower third of ranked states but well clear of the bottom.
For comparison, New York leads at $317.60 a day and Massachusetts pays $231.13. At the low end, Missouri pays $178.98, South Carolina $173.92 and Arkansas $80.36. Idaho's rate is closer to the bottom group than to the top, but only by a few dollars a day.
Idaho's coverage rules list one prior authorization rule on code 0651. An Idaho hospice should build that step into its admission workflow. A day billed without the required authorization is a day of care delivered without payment.
Continuous home care pays for predominantly nursing care at home during a crisis. Idaho pays $16.22 per 15 min unit on revenue code 0652, which is $64.88 an hour. That ranks 12th of 16 states and is 1.9% below the $66.11 national median.
Billing in quarter-hour units has a practical effect. An hourly rate rewards rounding up to a full hour; a 15 min unit pays more precisely for the time documented. For a hospice, that means accurate start and stop times on every continuous care shift translate directly into revenue.
Nationally, continuous home care runs in a narrow band, from $80.47 in Oregon down to $59.29 in West Virginia, with Kansas ($60.00) and Georgia ($62.08) also near the bottom. Idaho's $64.88 an hour sits above that bottom cluster.
Inpatient respite. Idaho pays $499.22 a day on revenue code 0655. Respite is a short inpatient stay that relieves family caregivers. Idaho's coverage rules limit respite per election period (calendar month), so a hospice planning respite stays should track usage against that limit for each patient. The national median for respite is $530.15, with Oregon highest at $629.83.
General inpatient care. Idaho pays $1,122.07 a day on code 0656 for short-term inpatient care when symptoms cannot be managed at home. The national median is $1,157.99, and the highest state, Oregon, pays $1,354.60. Idaho lists no prior authorization rules on 0655.
Federal occupational wage data for May 2025 shows a mixed picture for the Idaho hospice team:
- Registered nurse: $44.45 in Idaho, against $46.90 nationally
- Home health / personal care aide: $16.72, against $17.21
- Healthcare social worker: $35.82, against $32.63
- Chaplain: $28.64, against $29.24
Idaho's healthcare social worker median is above the national figure, the only hospice role where that is true. Nurse, aide and chaplain wages run slightly below national medians. Because social work is part of the interdisciplinary team that routine home care pays for, a higher social worker wage weighs on the routine home care rate, which is itself below the national median.
For continuous home care, an Idaho RN median of $44.45 against $64.88 an hour of reimbursement leaves a margin for supervision, travel and on-call coverage that is similar to the national picture.
Idaho updates hospice rates through Medicaid information releases:
- MA26-21 Hospice Rates SFY 2027, published 2026-09-21, effective 2026-10-01. This sets the rates on this page.
- MA25-22 Hospice Rates, published 2025-11-18, effective 2025-10-01.
The 2025 notice was published after its effective date, while the 2026 notice came out before its effective date, giving Idaho hospices time to update billing before the new rates applied.
The wider Idaho context matters too. Idaho published 4% provider rate reductions fee schedules, with projected rates effective 9/1/2025, and moved home health to a new SFY 2027 schedule under MA26-16, effective 2026-07-01. Hospice runs on its own October cycle, but a hospice that also operates a home health line, or that relies on home health agencies for referrals, should read those notices alongside the hospice release. Rate pressure on adjacent services often shows up in hospice as later referrals and shorter stays.
Idaho's coverage rules make the first days of a hospice stay an administrative task as well as a clinical one. Because routine home care on 0651 carries a prior authorization rule, the authorization request should go out with the election paperwork rather than after the first claim is prepared.
A practical sequence for an Idaho hospice:
- Confirm eligibility on the day of referral, including whether the member is in a dual-eligible program.
- Submit the authorization for routine home care alongside the hospice election.
- Record respite use against the calendar-month election-period limit as soon as any respite stay is planned.
- Document continuous care in quarter hours, with exact start and stop times, so every 15 min unit can be billed.
Idaho's information release MA26-19, Clarification On Claim Submission Expectations, published 2026-09-08, is worth reading alongside these steps, since claim submission practices affect how quickly hospice days are paid.
Idaho's managed-care data does not classify hospice as its own service line. Home and community-based services and personal care in Idaho are paid directly by the state, outside managed care. We list 7 plans in Idaho's data, including Molina Healthcare of Idaho and UnitedHealthcare Community Plan of Idaho, which serve dual-eligible members through Idaho's MMCP and IMPlus programs. A hospice serving members of those plans should confirm with each plan how hospice claims are routed. The Idaho managed care page has the plan list and the rules by line.
House Bill 345 (2025) directs Idaho Medicaid to move to comprehensive managed care, with the start delayed to January 1, 2030. Today, most Idaho Medicaid hospice claims are paid by the state at the published rates. Under comprehensive managed care, plans would take on a larger share of Medicaid members and services.
For hospices, the long lead time is useful. The questions to settle before 2030 are which plans will cover hospice, whether plans will be required to pay the published rate or allowed to negotiate, and how authorization will work. A hospice that tracks those decisions as they are made can plan contracts and billing systems well before the change.
Many hospice patients live in nursing facilities. Idaho issued MA26-18, an update to the additional terms of the nursing facility provider agreement, effective 2026-09-07, and publishes skilled nursing facility rates by quarter. When a nursing facility resident elects hospice, the facility continues to provide room, board and daily care, and the hospice adds its interdisciplinary team. A written agreement between the two providers covering medications, personal care and crisis response protects both sets of claims.
Idaho borders states that pay very differently. Oregon leads three of the four national hospice levels, while Utah and Wyoming publish their own schedules on the same levels. A hospice operating in the Inland Northwest or along the Utah border can compare those pages to see where Idaho's lower-half routine home care rate leaves it.
- Budget on $181.75 a day. Build cost per patient day from visit frequency and Idaho wages, watching social work costs.
- Bill continuous care precisely. Quarter-hour units reward accurate time records.
- Track respite by month. Keep a running count against the election-period limit.
- Plan for 2030. Follow the managed care transition so contracts are ready in advance.
The full Idaho dataset holds all 23,716 current Idaho Medicaid rates, with history back to 2008.
Each rate is compiled from official Idaho Medicaid publications, including the Hospice Fee Schedule FY2027 and information release MA26-21, and links to its source document. Wages are federal occupational medians for May 2025. The Idaho Medicaid rates hub covers Idaho's full fee schedules, and the national hospice page compares every state. Our methodology explains how daily, hourly and 15 min hospice rates are converted and ranked.