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Hospice Center

Spotlights
  • Annual Change in Medicaid Hospice Payment Rates [PDF, 140KB] -- Rates effective October 1, 2008 (posted September 11, 2008)
  • CMS-1548-F: The Hospice Wage Index for Fiscal Year 2009; Final Rule was published at the Federal Register on August 8, 2008.  As part of the provisions of this final rule, CMS is phasing-out and eventually eliminating an adjustment, the budget neutrality adjustment factor (BNAF), to the hospice wage index that was put into place over 10 years ago to help hospices through a transitional period to a new wage index.  The combined effects of a 25% reduction to the BNAF in FY 2009 and a 3.6% market basket update are estimated to increase payment to hospices in FY 2009 by 2.5%.  For more information, see the Fact Sheet. (Display Date:  July 31, 2008; Publication Date:  August 8, 2008) 
  • CMS recently posted a new Question & Answer providing guidance on CR 5567 as it relates to the reporting of "charges" on the hospice claim.  (posted July 21, 2008)
  • CMS recently posted a new Question & Answer providing clarification on CR 5971 and Signature Requirements in the Medicare Hospice Benefit.  (posted May 28, 2008)
  • The hospice aggregate cap amount for the 2008 cap year is $22,386.15. The cap amount is computed based on instructions given in Section 1814(i)(2)(B) of the Social Security Act. Please see the Hospice Aggregate Cap document for more information. (posted May 28, 2008)
  • CMS-1548-P: The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update the hospice wage index for FY 2009.  As part of that proposed rule, CMS also proposes a phased-in elimination of an adjustment, the budget neutrality adjustment factor (BNAF), to the hospice wage index that was put into place over 10 years ago to help hospices through a transitional period to a new wage index.  The combined effects of a 25% reduction to the BNAF in FY 2009 and an estimated 3.0% market basket update are estimated to increase payment to hospices in FY 2009 by 1.9%.  For more information, see the Fact Sheet. (Display Date: April 28, 2008; Publication Date: May 1, 2008; Comments due by 5pm on June 27, 2008) 

Medicare Learning Network (MLN) Spotlights

Go to the What's New page for the latest MLN products and announcements!  Check it often!


Important Links
Regulations and Related Transmittals
  • Hospice Regulations and Notices
  • Hospice Change Requests and Transmittals

Billing & Payment Information
  • Electronic Data Interchange (EDI)(Billing)- Medicare information on electronic transactions under HIPAA

Managed Care Information
  • Managed Care/ Health Plans General Information

Medicare Hospice Data
  • Hospice Data 1998-2005
  • Medicare Hospice Expenditures and Units of Care
  • Standard Analytical Files - Identifiable Data Files

Medicaid Information
  • Annual Change in Medicaid Hospice Payment Rates [PDF, 140KB] -- (posted 9/11/08)
  • State Medicaid Manual; (See Section 4305 - Hospice Services)

Enrollment, Participation, & Certification
  • Provider Enrollment Information
  • CMS-855: Enrollment Forms
  • Conditions of Participation: Hospice
  • Survey & Certification - Certification & Compliance: Hospice
  • Survey & Certification - Guidance to Laws & Regulations: Hospice
  • CMS-417: "Hospice Request for Certification in the Medicare Program" Form
  • Survey & Certification - Policy & Memos to States and Regions: Hospice

Educational Resources
  • Medicare Learning Network (MLN)
  • MLN Educational Web Guides
  • MLN Matters Articles (Search)
  • MLN Products
  • MM5117 - Special Issues Associated with the Advance Beneficiary Notice (ABN) for Hospice Providers and Comprehensive Outpatient Rehabilitation Facilities (CORFs)

Beneficiary Notices Initiative
  • Overview Use Advanced Beneficiary Notice (FFS ABN-G)
  • Expedited Determination Notice

Uninsured Information
  • FAQs on charges for the uninsured (PDF, 103KB)
  • FAQ regarding offering discounts to the uninsured (PDF, 8KB)
Demonstration
  • Rural Hospice Demonstration
  • Active Projects Report - Evaluation of Rural Hospice Demonstration

Coding
  • Healthcare Common Procedure Coding System (HCPCS)
  • HCPCS Release and Code Sets
  • ICD9-CM Coordination and Maintenance Committee
  • ICD-9-CM Diagnosis and Surgical Codes
  • Claim Adjustment Reason and Remittance Advice Remark Codes The latest HIPAA codes are available at the Washington Publishing Company (WPC) Website.

Hospital Value-Based Purchasing
  • Agenda - April 12, 2007 Listening Session
  • Slide Presentations - April 12, 2007 Listening Session
  • Options Paper 2nd Public Listening Session
  • Audio Download of the January 17th Listening Session [Mp3]
  • Agenda - January 17, 2007 Listening Session
  • Slide Presentations - January 17, 2007 Listening Session
  • Medicare Hospital Value-Based Purchasing Plan Development Issues Paper

Medicare Prescription Drug Coverage
  • Information for Providers

National Provider Identifier (NPI)
  • National Provider Identifier (NPI) Information for Medicare FFS Providers

CMS Manuals & Transmittals
  • CMS Manuals
  • CMS Internet-only Manuals
  • Program Transmittals
  • To receive changes to the CMS Quarterly Provider Update, subscribe to the CMS-QPU Listserv/ Email Updates list.
  • Medicare Benefit Policy Manual; Chapter 9 - Coverage of Hospice Services Under Hospital Insurance
  • Medicare Claims Processing Manual; Chapter 11 - Processing Hospice Claims
  • State Operations Manual
  • State Medicaid Manual; (See Section 4305 - Hospice Services)Medicare General Information, Eligibility, and Entitlement Manual; Chapter 4 - Physician Certification and Recertification of Services- (See Section 60 - Certification and Recertification by Physicians for Hospice Care)
  • Provider Reimbursement Manual - Part II
  • Medicare National Coverage Determinations Manual

Medicare Secondary Payer
  • Medicare Secondary Payer Manual
  • Medicare Coordination of Benefits

Fraud & Abuse
  • Beneficiary Complaint Response Program
  • Physician Self-Referral

How to Stay Informed
  • Open Door Forums- Home Health, Hospice & Durable Medical Equipment
  • Questions and Answers: Hospice
  • Press Releases: CMS Media Release Search

General Provider Information - Coverage
  • Medicare Coverage
  • Medicare Coverage Database
  • Medicare National Coverage Determinations Manual

Guidance
  • Medicare Modernization Update
  • Health Insurance Portability and Accountability Act (HIPAA)

Contacts
  • Contact Your Regional Home Health Intermediary (RHHI)
  • Quality Improvement Organizations
  • CMS Regional Offices
  • Contacting the COBC

 

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