Hospice Aggregate Cap (CAP)
The hospice aggregate cap is the annual statutory limit on total Medicare payments an individual hospice may retain, calculated from the applicable per-beneficiary cap amount and beneficiary count. Medicare payments above the calculated cap must be repaid.
Definition
The hospice aggregate cap is the annual statutory limit on total Medicare payments an individual hospice may retain, calculated from the applicable per-beneficiary cap amount and beneficiary count. Medicare payments above the calculated cap must be repaid.
Why it matters
Hospices must monitor cap exposure throughout the year because patient mix, length of stay, and payment timing can create a material repayment obligation.
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