Hospice · 42 CFR 418.309(c)

The Capculator

The patient-by-patient proportional method, worked one beneficiary at a time. Enter each Medicare beneficiary who received care from you during the cap year and the engine returns your beneficiary count, your aggregate cap, and what you owe or have left.

How the count works

Days of care furnished by your hospice in this cap year

That patient’s total days of care in all hospices, all years

the fraction of a beneficiary
you may count

Sum those fractions across every beneficiary you served, multiply by the cap amount for the year, and you have your aggregate cap. A patient you cared for start to finish counts as a whole; one you shared with another hospice, or who carried days in from a prior cap year, counts as a slice.

42 CFR 418.309(c)(1) · patient-by-patient proportional methodology

Step one · the cap year

Cap year

Cap amount per beneficiary ($)

FY 2026 amount published by CMS. Prior years are provided for retrospective review; confirm against your cap determination letter before relying on any figure.

Step two · one row per beneficiary

0 of 5 rows completed

Beneficiary ID

Election date

Days this cap year

Total days, all hospices & years

Medicare payments ($)

Fraction

This demonstration is limited to five beneficiaries. The underlying engine has no row limit — a full cap review runs your entire PS&R beneficiary file.

Within cap.

0.0000

Medicare beneficiaries counted

Aggregate cap

Total Medicare payments

Remaining under cap

Summary of entered data

Payments against each beneficiary’s cap share

Fractions are shown to four decimal places and carried at full precision in the totals. This tool implements the proportional counting method only; it does not model benefit-period resets, the inpatient limitation at 42 CFR 418.302(f), or contractor adjustments made after the determination. Confirm every figure against your cap determination letter.

Five rows is a demonstration. Your cap year is a spreadsheet.

Send us the beneficiary file and we’ll run the full proportional calculation, reconcile it against your determination letter, and show you which admissions moved the number.

Request a cap review →