How to start a hospice in Arizona

Arizona requires a Health care institution license — hospice service agency or hospice inpatient facility from Arizona Department of Health Services, Bureau of Medical Facilities Licensing to operate a hospice. Fee: $50 application fee when the application is filed. License fee due after the initial inspection: $482 with no licensed capacity (hospice service agency); 1-59 beds $482, 60-99 beds $964, 100-149 beds $1,445, 150+ beds $2,409, each plus $127 per bed (hospice inpatient facility); $482 for each satellite on a single group license.

License required

Yes

License

Health care institution license — hospice service agency or hospice inpatient facility

Issuing agency

Arizona Department of Health Services, Bureau of Medical Facilities Licensing

Fee

$50 application fee when the application is filed. License fee due after the initial inspection: $482 with no licensed capacity (hospice service agency); 1-59 beds $482, 60-99 beds $964, 100-149 beds $1,445, 150+ beds $2,409, each plus $127 per bed (hospice inpatient facility); $482 for each satellite on a single group license.

Medicare oversight

CMS places hospices in this state that newly enroll in Medicare, reactivate, or change ownership into a Provisional Period of Enhanced Oversight (medical review such as prepayment review). It began 2023-07-13 for Arizona.

Medicare certification

Medicare certification is separate from the state license (state survey or CMS-approved accreditor). CMS imposed a nationwide 6-month moratorium on new Medicare hospice enrollments (including new practice locations) effective 2026-05-13, extendable in 6-month increments; applications received by the Medicare contractor before that date are still processed, accreditation cannot be used for deemed-status entry during the moratorium, and a hospice undergoing a non-exempt ownership change within 36 months of enrollment must re-enroll as new and is therefore blocked. The federal notice leaves Medicaid/CHIP hospice moratoria to each state.

Regulation

A.R.S. Title 36, Chapter 4; Ariz. Admin. Code Title 9, Chapter 10 (fees at R9-10-106; hospice rules in Article 6)

1. Submit the health care institution license application with the $50 application fee
2. Pass the ADHS initial inspection
3. Pay the license fee (base fee plus per-bed fee for an inpatient facility) using the remittance form
4. Receive the license

Program

Arizona Health Care Cost Containment System (AHCCCS)

Enrollment portal

AHCCCS Provider Enrollment Portal (APEP)

Fiscal agent

None — AHCCCS runs provider enrollment and its own claims system in-house

Application fee

AHCCCS charges the enrollment fee to non-individual provider types at enrollment and can charge it again at revalidation; AHCCCS lists $750 for calendar year 2026, matching Medicare's fee. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

AHCCCS requires the fingerprint-based criminal background check (FCBC) only for high-risk provider types. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

AHCCCS applies site visits to moderate- and high-risk provider types, at enrollment and at revalidation. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

AHCCCS requires revalidation every four years (stricter than the federal five) and may call for off-cycle revalidation; providers get 90 days from notice or their enrollment is terminated. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Arizona Medicaid enrollment guide →

CON program

No

Agency

Arizona Department of Health Services (ambulance certificates of necessity only)

Arizona certificate of need details →

State minimum wage

$15.15 an hour

Effective

2026-01-01

Scheduled increases

Rises to $15.65 on 2027-01-01 (annual CPI adjustment announced by the Industrial Commission).

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Hospice agencies (community based) — active organization NPIs (NPPES)

771 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

237 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,611,827 (as of Jun 1, 2026)

All Arizona Hospice Medicaid rates, ranked →