What is your hospice’s SSVI score?
The Service and Spending Variation Index (SSVI) is a CMS claims-based scoring system that flags hospice providers whose care patterns and Medicare spending differ significantly from national peers. It combines a Non-Hospice Spending Score and a Utilization Score, covering measures such as live discharges, visit intensity, weekend coverage, and long lengths of stay, to identify hospices with potentially concerning utilization behavior. SSVI runs from 0 to 16, and lower is better.
Lower is better.The score runs 0–16: up to 8 points for Medicare spending outside the hospice benefit, plus up to 8 for utilization patterns.
CMS labels 0 the target range and 16 the highest outliers. The bands in between are a reading aid used on this page, not a CMS classification.
Covering 7,089 hospices across FY2024 and FY2025. Loaded September 23, 2026.
Median SSVI across the country
Each tile is a state, shaded by its median SSVI score. Scores are only comparable within a single year. CMS re-benchmarks the thresholds annually.
Dashed tiles indicate states with no hospice agencies in this year’s data. Hover over any state for a quick look at its breakdown, and click a state to keep that breakdown on screen and filter the tool to that location. Click it again, or the ✕, to release it.
How the score works
Non-Hospice Spending Score (0–8)
This score reflects the amount of Medicare spending that occurs outside the hospice benefit during a patient's hospice election, including hospitalizations, emergency department visits, and other Part A or Part B services. CMS groups each hospice's total non-hospice spending into eight dollar-based bands. A hospice is assigned the point value of the band it falls into, with the lowest band scoring 1 and the highest scoring 8. Hospices with no non-hospice spending receive a score of 0.
Utilization Score (0–8)
This score is derived from eight independent yes/no evaluations of a hospice's care delivery patterns, including the provision of continuous home care or general inpatient care, levels of care delivered in nursing facilities, visit intensity near the end of life, length of stay and live discharge patterns, nursing minute levels, weekend visit frequency, and re-enrollment following live discharge. Each criterion contributes one point when met; the points are summed to produce the hospice's total utilization score.
SSVI Score (0–16)
The SSVI is the sum of those two scores — it is not a third, separate measure. A hospice scoring 6 on spending and 3 on utilization has an SSVI of 9. Because every point traces to a specific component, any score breaks down into exactly which spending band the hospice fell into and which utilization checks it triggered.
Reading it responsibly
Scores are relative to their own year
CMS recalibrates all SSVI thresholds each year based on the updated national distribution of hospice utilization and spending. Spending bands and utilization cut-offs may shift from year to year. As such, a hospice may see its score change from year to year even if its underlying behavior did not. Year-over-year movement should be interpreted as a signal to review the component measures rather than as a standalone result.
SSVI is not a quality measure
The SSVI does not assess quality of care, patient or family experience, clinical outcomes, staffing, compliance, or fraud. Instead, CMS uses it as a program integrity tool to identify unusual patterns in spending and service utilization. The SSVI is not currently linked to payment.
Not every hospice appears in every year
A hospice with no Medicare claims in a fiscal year has no score for that year — shown here as no data rather than as a zero. New hospices and those with very low volume are the usual reason.