Hospice accounting
Hospice Accounting Services
Cost reports, aggregate cap monitoring, and clean books for hospice agencies, from CPAs who specialize in healthcare.
- CPA firm since 1985
- 20+ years in healthcare
- 5.0 on Google · 16 reviews
Why it matters
Accounting Built Around How Hospice Actually Works
We serve hospices nationwide, fully remote, from our office in Lisle, Illinois. Hospice accounting is unlike any other healthcare specialty. Between Medicare Aggregate Cap (CAP) liability tracking, hospice cost report filing, and the unique revenue rules that govern per diem payments, most general accountants simply don't have the knowledge base to serve a hospice organization effectively.
Soriaga & Associates, LLC has been a CPA firm since 1985, with 20+ years in healthcare accounting. We understand CAP thresholds, election periods, and how to structure your financials to support compliance and reduce audit risk.
What we handle for hospice agencies
- Medicare CAP period liability calculation and monitoring
- Hospice cost report preparation and filing
- Monthly bookkeeping aligned with hospice per diem revenue
- Payroll for clinical and administrative staff
- Business and owner tax preparation and planning
- Fractional CFO services for growing hospice agencies
- IDOA and DHS cost report preparation
- Audit support and documentation
Hospice cost reports at a flat fee
Medicare-certified hospices file an annual cost report with CMS. We prepare and file it for a flat fee of $1,599.99, or $500 if your hospice had no utilization.
See Medicare cost report filing for what is included and how the process works.
How much does hospice accounting cost?
Monthly retainers starting from $800 per month. A retainer can include bookkeeping, payroll, tax planning and filing, and cost report support. The exact fee depends on the size and scope of your hospice, and we confirm it in writing after your free 20-minute call.
We serve hospices in all 50 states, fully remote. See our pricing page for every fee.
How we work with your hospice
Getting started is simple, and you know the cost before we begin.
- 01Free 20-minute call. We learn about your hospice, your books and what you need help with.
- 02Written flat-fee quote. You get the price in writing before any work starts.
- 03Onboarding and catch-up. We take over your books and clean up anything that is behind.
- 04Monthly close and review. We close your books each month and review the numbers with your CPA.
We work in QuickBooks Online and QuickBooks Desktop, and Xero if needed. Ready to start? Book a free 20-minute call.
Understanding the Medicare hospice aggregate cap
The Medicare Aggregate Cap limits the total Medicare payments a hospice agency can receive. The aggregate cap is calculated per cap year (October 1 – September 30): the number of Medicare beneficiaries served times the annual cap amount, compared with total Medicare payments. Within five months after the cap year ends, your hospice files its self-determined cap calculation with your Medicare Administrative Contractor (MAC), which reviews it. Agencies that exceed the cap must repay the excess to Medicare — which can be a significant liability if not tracked carefully throughout the year.
How we monitor your aggregate cap
We track your cap position every month, so you see where you stand against the cap long before the cap year closes on September 30. If your numbers point toward an overage, we flag it early, while you can still adjust admissions and census decisions.
To estimate your own position now, use our free hospice cap calculator.
Illinois hospices
Our office is in Lisle, so Chicagoland hospices can meet us in person. We also prepare IDOA and DHS cost reports for Illinois agencies.
Client reviews
What our clients say
5.0 from 16 Google reviews
“Soriaga & Associates LLC has expertly handled our Medicare Cost Report preparation and filing for several years. They are reliable professionals ensuring compliance and efficiency in filling out cost reports. They respond quickly to emails and provide proactive support.”
“I've been working with this Accounting firm for many years across multiple companies, and they've consistently delivered exceptional service... a team you can truly depend on.”
“Very professional, completed all our company tasks in a timely manner, we will certainly recommend.”
FAQ
Frequently asked questions
Still have questions? Ask them on a free 20-minute call.
Does my hospice agency need to file a Medicare cost report?
Yes. All Medicare-certified hospice agencies must file an annual cost report with CMS. Deadlines are typically 5 months after your fiscal year end. We handle the entire process — preparation, review, and submission.
What is the Medicare Hospice CAP and how is it calculated?
The aggregate cap is figured for each cap year (October 1 – September 30): the number of Medicare beneficiaries you served times the annual cap amount, compared with your total Medicare payments. Your hospice files this self-determined calculation with your MAC within five months after the cap year ends. If your total Medicare payments exceed that figure, you must repay the difference. We monitor your cap position monthly.
Can a general CPA prepare our hospice cost report?
Technically yes, but it's risky. Hospice cost reports involve specific schedule structures, provider-based service allocations, and CAP reconciliation requirements that general practitioners rarely encounter. An error can trigger a Medicare audit or require a costly amended filing.
How much does hospice accounting cost?
Our monthly retainers start from $800 per month. A retainer can include bookkeeping, payroll, tax planning and filing, and cost report support. The exact fee depends on the size and scope of your hospice and is confirmed in writing after your free 20-minute call. We serve hospices in all 50 states, fully remote.
Serving hospice agencies in Lisle, Naperville, Westmont, Chicago, Oak Brook, Downers Grove, Joliet, Aurora, and throughout Illinois.
Call 630-491-1268 for a free hospice accounting consultation.
Related pages: Free hospice cap calculator · Free hospice rate calculator · Switching accountants · Hospice cost report benchmarks · Hospice Billing Guide: Levels of Care, Revenue Codes, NOEs and the Aggregate Cap · New Hospice LLC: Cap Tracking, Cost Report and Bookkeeping in Year One
Free 20-minute call
Stay ahead of your hospice CAP.
Talk directly with Christian Soriaga, CPA. No pitch deck, no obligation.
On the call we’ll cover
- Your situation and what is due next
- Deadlines and filing status
- A clear written fee quote
- Clear next steps, no obligation
Christian Soriaga, CPA
Soriaga & Associates, LLC