The purpose of this Transmittal is to inform you of changes to Hospice payment rates effective February 1, 2016 through September 30, 2016. The Medicaid payment rate for Routine Home Care (RHC) has been changed to reflect a two-tiered routine home care rate and a Service Intensity Add-On (SIA) payment. This two-tier routine reveals the first significant change to the hospice payment methodology.