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. This page explains what the rates mean for a Utah hospice, how the wage market and managed care shape them, and which policy notices to read before billing.
| 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.
Utah uses the four standard HCPCS hospice codes, one per level of care, which makes it easy to compare with other states that use the same series.
Daily levels
Routine home care, T2044 respite and T2045 general inpatient care are each paid per day. A routine day pays the same whether the team visits once or not at all.
The hourly level
T2043 continuous home care is paid by the hour during a crisis that requires predominantly nursing care at home. That is why it can be ranked directly against other hourly states.
Traditional and Non-Traditional plans
Utah's fee-for-service program has a Traditional plan and a Non-Traditional plan, a reduced benefit plan for some adult expansion members. The hospice rates here are published under the Traditional plan; a hospice should confirm the member's benefit plan at admission.
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. Respite is often what keeps an exhausted caregiver able to continue, which in turn keeps the patient at home on routine care for longer.
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.
A near-median routine rate puts the focus on cost control. The days after admission and before death are the most visit-intensive, while a stable patient in mid-stay may need only a few visits a week. Hospices that track their cost per routine day by stage of stay see where the margin comes from. In rural Utah, drive time is part of that cost and can decide whether a distant patient's routine days are profitable.
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.
Both levels are nursing-heavy. For a hospice without its own inpatient unit, the general inpatient rate sets the ceiling on what it can pay a contracted hospital or nursing facility while still covering its own oversight. Utah's above-median rate gives more room in those negotiations than most states.
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.
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 Medicaid Information Bulletin (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. Without a prior authorization step, documentation is the main safeguard: a claim that is later reviewed rests on the certification, election and plan of care in the record.
Our data names 27 plans in Utah Medicaid, including medical plans such as Healthy U, Molina Healthcare of Utah, SelectHealth Community Care and Healthy Outcomes Medical Excellence (HOME). For hospice, Utah's rule is that plans negotiate their own rates, and the published rate applies out of network. Home health follows the same rule, while nursing facilities, personal care and home and community-based services are paid directly by the state, outside managed care.
In practice, the fee-for-service rate is the reference point in every plan negotiation rather than a guaranteed floor. A plan offer below the published rate pays less than an out-of-network claim would. A hospice should ask each plan whether its rates follow the state's October updates. The Utah managed care page shows the rule for each line.
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. For a multi-state operator, it rewards hospices that deliver the full range of care rather than routine days alone.
Neighbouring markets make the point. Oregon and Washington pay more on continuous care, while Utah ranks just ahead of Wyoming and Arizona on general inpatient care. A hospice comparing Utah with a neighbouring state should weight each level by its own mix of patient days: a program that is almost all routine care will find Utah close to typical, while one that offers crisis care and inpatient beds will find it among the better-paying states.
The wage profile adds a second layer. Below-median nurse wages make Utah's above-median nursing-heavy levels more valuable, but above-median social worker wages raise the cost of the psychosocial support every hospice must provide.
- Budget each level separately, with routine days as the base and respite, continuous and inpatient days as upside.
- Negotiate plan contracts from the out-of-network rate, and confirm whether each plan follows the state's rate updates.
- Use the nurse wage advantage to build continuous care capacity, such as a small on-call crisis team.
- Offer respite actively. At a top-five rate, respite supports family caregivers and keeps patients at home longer.
- Read MIB 25-31 before updating billing and documentation workflows.
Rates on this page are compiled from official state Medicaid publications, and each rate links to its source document. The hospice figures come from Utah Medicaid's Traditional plan schedule, with the MIB notices named above for policy.
These hospice rates are part of all 44,888 current Utah Medicaid rates across 120 service categories. Compare Utah with every state on the hospice industry hub, see all Utah codes on the Utah Medicaid rates page, read our methodology for how hospice rates are ranked, and see pricing for full dataset access.