June 16, 2026
Access Your Hospice Cap Documentation in MCReF
Each year, hospice providers are required to file a self-determined hospice cap with their Medicare Administrative Contractor (MAC). MACs then perform an annual review and issue a:
- Hospice aggregate cap determination letter
- Self-determined hospice cap demand letter
Within 30 days of issuing these letters, MACs will upload the following information into the System for Tracking Audit and Reimbursement (STAR):
- Documentation for the hospice aggregate cap determination
- Copy of the demand letter issued for the self-determined cap
The packages will be available for hospice providers to access and download through the Medicare Cost Report e-Filing (MCReF) system.
See the CMS instruction
for details.

