Florida Medicaid Hospice Codes, Rates, and Fee Schedule 2026

Effective October 1, 2025, Florida Medicaid hospice reimbursement for 2026 follows a strictly structured fee schedule. Based on the new reimbursement rates and rules, getting paid accurately isn’t just about the care you provide, rather it’s about matching the care with precise revenue codes.

One wrong code or a careless mismatch can leave you chasing valuable revenue for months.

In today’s guide, we’ll break down the Florida Medicaid Hospice Fee Schedule for 2026 and the technical documentation to ensure you receive complete reimbursement.

Florida Medicaid Hospice Service Code Fee Schedule 2026

Revenue Code	Procedure Code	Services	Limitations	Reimbursement Rate
0182		Bed hold – Therapeutic leave	16 days/fiscal year	$180 to $300 per day
0185		Bed hold – Hospitalization	8 days/hospitalization	$180 to $290 per day
0184		Bed hold – ICF/IID hospitalization	8 days/hospitalization	$180 to $320 per day
0651		Routine home care	Days 0–60: High Rate; Days 61+: Low Rate	0 to 60 days =$224.8461+ days= $178.80
0551	G0299	SIA – Registered Nurse visit	15-min units, up to 4 hrs/day (combined with G0155)	$17.07 per unit
0561	G0155	SIA – Medical Social Worker visit	15-min units, up to 4 hrs/day (combined with G0299)	$17.07 per unit(details below)
0652		Continuous home care	8 hours or more than 8 hours per day.	$67.31 per hour
0654	Q5005 / Q5006	Room and board – ICF/IID		$180 to $320
0655		Inpatient respite care	up to 5 consecutive days per respite episode	$544.70 per day
0656		General inpatient care	care must be provided at hospital, hospice inpatient unit, and skilled nursing facility	$1164.47 per day
0657		Physician services	not used for RN visits	$28 to $55/ paid separately from hospice per day rates.
0658		Room and board – Nursing facility		$180 to $300

Note: These Florida Medicaid reimbursement rates are taken approximately and are subject to change. The 2026 rates became effective on October 1, 2025, and will remain in place through September 30, 2026.

Medicaid Reimbursement Rates for Hospice Services Revenue Codes in Florida

Hospice billing revenue codes identify the category of service provided, such as routine care,  inpatient care, or room and board. They help Medicaid determine how the service should be reimbursed based on facility type and location.

Revenue Code 0182 (Bed Hold Therapeutic Leave)

Healthcare providers bill revenue code 0182 when a bed in a care facility is reserved during a planned, temporary absence from the nursing facility or ICF/IID.

For example, the patient leaves the facility for a home visit, family time, or therapeutic leave. Florida Medicaid reimburses this service at a rate of $180 to $300 per day, with a maximum limit of 16 days per state fiscal year (July 1 through June 30).

Note: Bed must actually be reserved (not reassigned to another patient) otherwise claim can be denied in audit.

Revenue Code 0185 (Hospitalization Bed Hold)

Hospice Service Providers in Florida bill revenue code 0185 when a patient leaves a nursing facility due to a hospital admission. The facility may reserve the bed for up to 8 days.

The 8-day limit resets for each new hospitalization. For example:

• Hospital stay #1 → 6 days → all paid
• Later, hospital stay #2 → 7 days → all paid

Florida Medicaid covers both separately. The reimbursement rates for this service range from $180 to $290 per day, depending on the facility’s specific contract. However, if a single stay exceeds 8 bed-hold days, the Florida Medicaid will not cover the additional days of bed-hold.

Revenue Code 0184 (ICF/IID Residents During Hospitalization Bed Hold)

Providers utilize the revenue code 0184 when a patient in an ICF/IID (Intermediate Care Facility for Individuals with Intellectual Disabilities) is admitted to a hospital.

The facility keeps their bed reserved. It is the same as revenue code 0185, but specifically for ICF/IID facilities (not regular nursing facilities). Florida Medicaid reimburses this service at $180 to $320 per day, depending on the facility’s specific contract, and covers up to 8 bed-hold days per hospitalization. Additional bed-hold days after a new hospitalization follow the same rules as revenue code 0185.

Revenue Code 0651 (Routine Home Care)

Revenue code 0651 for Routine home care is the standard level of hospice service. It is the most frequently billed code. As a healthcare provider, you can use the 0651 code when a patient is stable (not in crisis) and care is provided at home or in a facility (nursing home/ ICF/IID).

Florida Medicaid reimburses the routine home care using a two-tier rate structure based on the number of days in the hospice benefit period. For example:

➜ Hospice Days 0–60 (High Rate): Florida Medicaid pays a higher daily rate for revenue code 0651 i.e., $224.84 for the first 60 days of the hospice benefit period.

➜ Days 61 and beyond (Low Rate): Starting from day 61, the Florida Medicaid’s daily reimbursement rate decreases to the lower rate, which is $178.80.

All services below are bundled into the 0651 daily rate and cannot be billed separately.

• RN visits
• Social worker visits
• Home health aide
• Medications related to hospice
• Medical equipment (DME)
• Care coordination

However, you can bill extra if only the patient is in the last 7 days of life then you add G0299 (RN) and G0155 (SW) on top of 0651.

Registered Nurse Visit (Revenue Code 0551/Procedure Code G0299): Service Intensity Add-On (SIA)

The Service Intensity Add-On (SIA) is a supplemental reimbursement that Florida Medicaid pays on top of routine home care (0651). It applies only during the last 7 days of an eligible recipient’s life.

Revenue Code 0551 paired with Procedure Code G0299 covers Registered Nurse (RN) visits during routine home care in this final period.

Billing for these services will be on a 15 minute by fifteen minute basis. The reimbursement rate for SIA (0551/G0299 & 0561/G0155) is $17.07/Unit.

Moreover, there is a combined daily cap of 4 hours shared with the Medical Social Service SIA (see Code 0561 below).

Note: SIA is an add-on payment, meaning you can still get 0651 daily rate plus extra payment for RN time.

For example, a patient is on 0651 ( $226/day) and with RN visits for 2 hours. You can bill:

• 0651 = daily rate
• 0551/G0299 = 2 hours SIA extra payment

Medical Social Service Visit (Revenue Code 0561/Procedure Code G0155): Service Intensity Add-On (SIA)

Medical Social Worker visits performed during Routine Home Care in the last seven days of an individual’s life are covered under Revenue Code 0561 with Procedure Code G0155.

Similar to RN visits, this service is billed in 15-minute units at a reimbursement rate of $17.07 per 15-minute unit.

SIA hours under G0299 and G0155 are combined toward a single 4-hour daily limit. If both a Registered Nurse and a Medical Social Worker provide services on the same day, their total hours cannot exceed 4 hours combined.

However, if both providers (RN and SW) deliver services at the same time, those concurrent hours count separately for each provider’s billing.

In simple words, when a Registered Nurse and Social Worker are present at the same time, each provider may record their own service time independently. However, the total SIA time for the patient on that day is still limited to 4 hours combined.

Revenue Code 0652 (Continuous Home Care)

Continuous home care is a higher-intensity level of service delivered during a period of medical crisis. To qualify for this level of billing and reimbursement, the provider must deliver care for most of the 24-hour period i.e. 8 or more than 8 hours.

Furthermore, there must be skilled nursing care (RN/LPN) for more than 50% of the care time.

Providers bill this under Revenue Code 0652. It reflects a more intensive and resource-heavy service level than routine home care. Florida Medicaid’s reimbursement rate for the continued home care is $67.31 per hour.

Revenue Code 0654 / Procedure Code Q5005 or Q5006 (Room and Board ICF/IID)

The revenue code 0654 covers room and board costs for hospice recipients residing in an ICF/IID facility. Based on the type of facility, Florida Medicaid reimburses it under Revenue Code 0654, using either procedure code Q5005 or Q5006.

Under this code (0654) FL Medicaid pays the facility for bed (residential stay), meals, basic care support, and 24/7 supervision. Procedure codes (Q5005 and Q5006) are used only to identify the type of facility.

• Q5005 = hospice care in skilled nursing facility
• Q5006 = hospice care in inpatient hospice facility

This code is distinct from the nursing facility room and board code (0658) and must not be used interchangeably.

The average Florida Medicaid 0654 rate is approx. $180–$320 per day. However, it may vary by facility and is not a fixed statewide amount.

Revenue Code 0655 (Inpatient Respite Care)

Inpatient respite care involves a short-term admission to an approved inpatient setting. Revenue Code 0655 is used when a caregiver requires temporary relief and the patient is placed in an approved inpatient facility such as a nursing facility, hospice inpatient unit, or hospital swing bed.

The code is strictly for short-term respite. Florida Medicaid covers up to 5 consecutive days per respite episode and reimburses this under revenue code 0655.

It is important to note that from the 6th day, the reimbursement automatically reverts to the lower Routine Home Care (0651) rate, regardless of where the patient is staying.

The reimbursement rate for inpatient respite care is $544.70 per day. This is a planned, temporary level of care and it is not for medical crises, which fall under general inpatient care (0656).

To protect your revenue, track the “Respite Clock” closely. If a patient exceeds 5 days, your billing team must switch the Revenue Code to 0651 immediately to avoid a technical denial.

Revenue Code 0656 (General Inpatient Care) GIP

General inpatient care (GIP) is billed when a hospice recipient requires a level of medical management that cannot be delivered in a home or residential setting. This includes complex pain management or symptom control requiring continuous nursing oversight. For example:

• Severe uncontrolled pain
• Respiratory distress
• Unmanageable nausea/vomiting
• Agitation or terminal delirium
• Rapid clinical decline

For payment eligibility, the care must be provided at a hospital, hospice inpatient unit, and skilled nursing facility (if contracted for GIP). Florida Medicaid covers this under revenue code 0656 and reimburses it on a per-diem basis at $1,164.47 per day.

Revenue Code 0657 (Physician Services)

Revenue code 0657 is used for physician-related services provided under the hospice plan of care. It covers physician evaluation and management, clinical decision-making, hospice attending physician services, medical director oversight (in some cases).

The 0657 is not used for RN visits (that is SIA or 0651 bundled care), social worker services, and facility room and board.

FL Medicaid reimburses revenue code 0657 using standard Medicaid Physician Fee Schedule (PFS) rates and not hospice per-diem rates. It must be billed with a procedure code (CPT/HCPCS) as each procedure.

Normal reimbursement rate ranges from $28 to $55 depending on the level of physician care services.

Revenue Code 0658 (Room and Board Nursing Facility)

Under the revenue code 0658, Florida Medicaid covers room and board costs for hospice recipients residing in a standard nursing facility. The facility receives payments for bed, meals, basic nursing care, and 24/7 supervision.

The functioning of revenue code 0658 is quite similar to code 0654. However, 0658 applies to nursing facilities while 0654 applies to ICF/IID facilities. The reimbursement rate for 0658 ranges between $180 to $300 per day based on the region and type of facilities.