Non-Hospice Spending Score SSVI Measure

In FY2025, 2.2% of scored hospices had no non-hospice spending at all, while 12.2% landed in the top (worst) spending bracket.

What CMS measures

While a patient is enrolled in hospice, Medicare expects nearly all of their care to flow through the hospice benefit. This score measures how much Medicare paid OUTSIDE the hospice benefit — Part A, Part B, and Part D claims — for your enrolled patients. Hospices with zero reported non-hospice spending score 0; everyone else is ranked into eight brackets, and the bracket number is the score (up to 8 of the 16 total SSVI points).

The flag threshold

• FY2025: Scored 0 (no non-hospice spending) to 8 (highest spending bracket); dollar brackets are recalculated every fiscal year.
• FY2024: Same 0–8 bracket structure with FY2024 dollar boundaries.

Percentile-based thresholds are recalculated by CMS every fiscal year, so the line moves as the industry moves.

Why hospices trip it

• Part D plans paying for medications related to the terminal illness that the hospice should be covering.
• Outside providers (hospitals, SNFs, physicians) unaware the patient elected hospice, billing Medicare directly.
• Weak "related vs. unrelated" determinations — care documented as unrelated to the terminal illness without support.

How to move it — changes you can start today

1. Run a medication reconciliation against Part D data for every current patient — any terminal-illness-related drug billed to Part D is non-hospice spending with your name on it.
2. Send the Notice of Election confirmation to every facility, attending physician, and DME supplier the day of admission so they bill you, not Medicare.
3. Document every "unrelated" determination with a physician narrative — if you cannot defend it, treat the service as related.
4. Check eligibility (HETS) monthly for admitted patients to catch outside claims early instead of at cost-report time.

Common questions

Does a high Non-Hospice Spending Score mean my hospice did something wrong?

No. CMS is explicit that the SSVI is not a finding of fraud, waste, or abuse. But high non-hospice spending is the single largest component of the SSVI (8 of 16 points), and it is the pattern CMS built the index to surface.

Can I see the dollar amount behind my score?

Yes — the free SSVI lookup tool on this site shows your per-day and total non-hospice spending for FY2024 and FY2025 alongside the CMS bracket boundaries.

Where does your hospice stand?

Look up your score free — the breakdown shows your raw value on this exact measure next to the CMS threshold. Or browse scores by state.

All nine SSVI measures

• Non-hospice spending (this page)
• No CHC or GIP days
• Facility-based RHC days
• Last 2 days skilled visits
• Long length of stay
• Live discharge rate
• SN minutes per RHC day
• Weekend skilled visits
• 7-day return rate