How to start a hospice in Pennsylvania

Pennsylvania requires a Hospice agency license (Health Care Facilities Act, Chapter 8) from Pennsylvania Department of Health, Division of Home Health to operate a hospice. Fee: $250. Processing time: Missing items must be supplied within 30 days of the Department's email or the application is denied; overall time depends on application accuracy.

License required

Yes

License

Hospice agency license (Health Care Facilities Act, Chapter 8)

Issuing agency

Pennsylvania Department of Health, Division of Home Health

Fee

$250

Fee details

$250 per license, by check or money order mailed to the Division of Home Health (application is not reviewed until the fee arrives).

Processing time

Missing items must be supplied within 30 days of the Department's email or the application is denied; overall time depends on application accuracy.

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

Health Care Facilities Act, 35 P.S. § 448.101 et seq. (Chapter 8); 42 CFR Part 418 used as the licensure review standard

1. Complete the Initial Hospice Application and e-mail it to the Division of Home Health
2. Mail the $250 fee by check/money order
3. Submit policies and staff documentation showing substantial compliance with 42 CFR Part 418 (patient rights, assessments, IDG, QAPI, infection control, licensed professional services, core services)
4. Inpatient units: submit construction plans to the Division of Safety Inspection
5. Host the on-site inspection; do not admit patients until approved
6. For Medicare: submit CMS-417, CMS-690 and CMS-1561 to the Division, CMS-855A to the contractor, and OCR civil rights information; the Department surveys after CMS approves the 855A (state licensure is a prerequisite)

Program

Pennsylvania Medical Assistance (Medicaid) / HealthChoices, PA Department of Human Services, Office of Medical Assistance Programs

Enrollment portal

PROMISe Provider Portal — Electronic Provider Enrollment (PE) Application

Fiscal agent

PROMISe (DHS claims and enrollment system); the DHS electronic enrollment manual was prepared by Gainwell

Application fee

Since February 27, 2023, applicants pay the enrollment application fee described in MA Bulletin 01-16-14 ('ACA Enrollment Application Fee'). To claim an exemption, submit the documentation that bulletin describes. Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts.

Fingerprinting

High-risk providers must complete fingerprint-based criminal background checks; this requirement returned February 27, 2023 (MA Bulletin 99-16-13 sets the risk levels). If fingerprints are not submitted, the service location in PROMISe is closed. Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check.

Site visit

Moderate- and high-risk providers get a site visit from DHS or its contractor (MA Bulletin 99-16-13). If the visit cannot confirm the application, for example because the location is not operating, or the provider does not cooperate, the service location is closed.

Revalidation

Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. DHS sends revalidation notices 90 and 30 days before the due date (MA Bulletin 99-16-10 has the details). The revalidation date is visible in ePEAP. A missed due date closes the service location in PROMISe, and the provider must then file a reactivation application.

Full Pennsylvania Medicaid enrollment guide →

CON program

No

Pennsylvania certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

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)

478 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

179 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

2,952,912 (as of Jun 1, 2026)