What is Routine Home Care? Hospice RHC level of care

Routine Home Care (RHC) is the level of care every hospice team spends most of their time delivering — visits at the patient’s residence, whether that’s their own home, an assisted-living building, or a long-term-care facility.

By Goodwin Hospice Academy Editorial Team· Published February 16, 2026·Last reviewed February 16, 2026· 5 min read

RHC, in one sentence

RHC is the standard, non-crisis Medicare hospice level of care delivered wherever the patient calls home.

What "home" means

For hospice purposes, "home" is any residential setting the patient considers their residence — a private home, apartment, assisted-living community, group home, or long-term-care facility. Facility placement does not disqualify a patient from RHC.

Visit patterns under RHC

RHC includes RN case-management visits, hospice aide visits, social-worker visits, chaplain visits, and volunteer support. Visit frequency is driven by the plan of care, not a per-day billing target.

RHC per-diem structure

RHC is paid on a per-diem basis with a two-tier structure: a higher rate for the first 60 days of an election and a lower rate for days 61 and beyond, plus a Service Intensity Add-On (SIA) for the last 7 days of life. Confirm current rates on CMS.gov.

Frequently asked questions

Can a patient in a nursing home be on RHC?

Yes. Nursing-home residents receive RHC when the nursing home is considered the patient’s home; the hospice provides all four disciplines under the plan of care.

What is the RHC per-diem rate?

RHC has a higher rate for the first 60 days of an election and a lower rate thereafter. Confirm current amounts on CMS.gov and the annual payment rule.

What is the SIA?

The Service Intensity Add-On is an extra payment for the last 7 days of life to encourage direct-patient-care visits by RNs and social workers.

Sources & further reading

Educational content only. Not a substitute for your organization’s policies, your medical director’s clinical judgment, or current CMS guidance.

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