Accounting Built Around How Hospice Actually Works

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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.

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Soriaga & Associates has been serving hospice agencies across 
Illinois for over 25 years. We understand CAP thresholds, election 
periods, and how to structure your financials to maximize compliance 
and minimize audit exposure.

WHAT WE HANDLE FOR HOSPICE AGENCIES

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• 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

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UNDERSTANDING THE MEDICARE HOSPICE AGGREGATE CAP

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The Medicare Aggregate Cap limits the total Medicare reimbursement a 
hospice agency can receive per beneficiary in a given fiscal year. 
Agencies that exceed the CAP threshold must repay the excess to 
Medicare — which can be a significant liability if not tracked 
carefully throughout the year.

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At Soriaga & Associates, we monitor your CAP position monthly, flag 
potential overage risk early, and help you make informed census 
decisions before the liability crystallizes at year end. Our clients 
don't get surprised by CAP repayment obligations.

 

 

FREQUENTLY ASKED QUESTIONS

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Q: Does my hospice agency need to file a Medicare cost report?
A: 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.

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Q: What is the Medicare Hospice CAP and how is it calculated?
A: CMS calculates the total number of beneficiaries you served and 
multiplies that by the annual CAP amount. If your total Medicare 
reimbursements exceed that figure, you must repay the difference. 
We track this calculation in real time throughout the year so there 
are no surprises.

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Q: Can a general CPA prepare our hospice cost report?
A: 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.

 

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.