Hospice Center
Spotlights
- CMS-1434-N: The Centers for Medicare & Medicaid Services (CMS) issued a notice to update the Medicare Hospice Wage Index for fiscal year (FY) 2013. This notice also provides clarification on additional diagnoses reporting on hospice claims and updates on hospice payment reform and hospice quality reporting. Hospices serving Medicare beneficiaries will see an estimated 0.9 percent increase in their payments for FY 2013. The hospice payment increase is the net result of a 1.6 percent increase in the “hospital market basket” update, which is offset by a 0.7 percent decrease in payments to hospices due to updated wage index data and the fourth year of CMS’ 7-year phase-out of its wage index budget neutrality adjustment factor (BNAF).
On June 1, 2012, CMS issued CR 7838, entitled “Updates to Caps and Limitations on Hospice Payment”, which moved the cap section of the hospice claims processing manual (IOM 100-04, chapter 11, section 80) to the hospice benefit policy manual (IOM 100-02, chapter 9, new section 90). CR 7838 also updated the aggregate cap policy to reflect the changes in cap policy which were finalized in the August 4, 2011 Hospice Wage Index Final Rule.
- The Centers for Medicare & Medicaid Services (CMS) recently issued Change Request (CR) 7675 entitled "Revisions to the Hospice Medicare Summary Notice (MSN)" and CR 7677 entitled "New Hospice Condition Code for Out of Service Area Discharges". Both CRs will be effective July 1, 2012.
- Correction to CMS-1355-NR [PDF, 183KB] (Text Version), "Hospice Wage Index for Fiscal Year 2012", which was published in the Federal Register on May 9, 2011: This Notice of Ruling was corrected to show the correct title, "Hospice Appeals for Review of an Overpayment Determination." Additionally, this Notice of Ruling was corrected change the effective date of this Notice of Ruling from "April 14, 2011" to "May 9, 2011". (Posted July 22, 2011)
- CMS-1355-R / CMS-1355-NR: Ruling (Issue Date: April 14, 2011; Publication Date: May 9, 2011). CMS issued a Ruling, effective April 14, 2011, establishing CMS policy related to when a hospice challenges the validity of the beneficiary counting methodology in its appeal of an overpayment determination for any hospice cap year ending on or before October 31, 2011. (Posted May, 6 2011)
- Do you want to find out Medicare Fee-for-Service information quickly? Subscribe to a CMS Electronic Mailing Lists: Keeping Medicare Fee-For-Service Providers Informed [PDF, 410KB] , such as the Hospice listserv, that suits your needs!
Medicare Learning Network (MLN) Spotlights
Go to the page for the latest MLN products and announcements! Check it often!
Important Links
Regulations and Related Transmittals
Billing & Payment Information
- Electronic Data Interchange (EDI) (Billing) - Medicare information on electronic transactions under HIPAA
- Hospice Aggregate Cap Amount for 2011
- Hospice Aggregate Cap Amount for 2009
- Hospice Aggregate Cap for 2008
Wage Index Files
- FY 2013 Wage Index [ZIP, 468KB]
- FY 2012 Final Wage Index [ZIP, 33KB]
- FY 2011 Final Wage Index [ZIP, 33KB]
- FY 2010 Wage Index [ZIP, 32KB]
- FY 2009 Wage Index [PDF, 249KB]
Managed Care Information
Medicare Hospice Data
- Medicare Hospice Data
- Hospice Data 1998-2009 [ZIP, 217KB]
- Hospice Data 1998-2008 [ZIP, 122KB]
- Standard Analytical Files
Medicaid Information
- FY 2013 Medicaid Hospice Payment Rates [PDF, 91KB]
- FY 2012 Medicaid Hospice Payment Rates [PDF, 88KB]
- FY 2011 Medicaid Hospice Payment Rates [PDF, 109KB]
- Revised FY 2010 Medicaid Hospice Payment Rates [PDF, 95KB]
- State Medicaid Manual ; (See Section 4305 - Hospice Services)
Enrollment, Participation, & Certification
- Medicare Provider-Supplier Enrollment
- Enrollment Applications
- Hospice Conditions for Coverage (CfCs) & Conditions of Participations (CoPs)
- Hospice Survey & Certification - Certification & Compliance
- Hospice Survey & Certification - Guidance to Laws & Regulations
- CMS-417: "Hospice Request for Certification in the Medicare Program" Form
- Survey & Certification Policy & Memos to States and Regions
Educational Resources
- MLN General Information
- MLN Educational Web Guides
- MLN Matters Articles ( Search Tips )
- MLN Products
- MM5117 [PDF, 91KB] - Special Issues Associated with the Advance BEneficiary Notice (ABN) for Hospice Providers and Comprehensive Outpatient Rehabilitation Facilities (CORFs)
Beneficiary Notices Initiative
- Beneficiary Notices Initiative (BNI) - Use Advanced Beneficiary Notice (FFS ABN-G)
- FFS ED Notices
Uninsured Information
Hospice Face-to-Face
- Hospice Face-to-Face Guidance PowerPoint [PDF, 232KB]
- Update on Physician Signature Requirement and Face-to-Face Encounter Requirements [PDF, 37KB]
Quality Initiatives
Other Important Hospice Information
Demonstration
- Rural Hospice Demonstration
- Active Projects Report - Evaluation of Rural Hospice Demonstration
Coding
National Provider Identifier (NPI)
CMS Manuals & Transmittals
- Manuals
- Internet-Only Manuals (IOMs)
- Transmittals
- To receive changes to the/ CMS Quarterly Provider Update, subscribe to the CMS Quarterly Provider Updates list.
- Medicare Benefit Policy Manual; Chapter 9 - Coverage of Hospice Services Under Hospital Insurance [PDF, 415KB]
- Medicare Claims Processing Manual; Chapter 11 - Processing Hospice Claims [PDF, 439KB]
- State Medicaid Manual ; (See Section 4305 - Hospice Services) Medicare General Information, Eligibility, and Entitlement Manual; Chapter 4 - Physician Certification and Recertification of Services [PDF, 104KB] - (See Section 60 - Certification and Recertification by Physicians for Hospice Care)
- Provider Reimbursement Manual - Part II
- National Coverage Determinations (NCD) Manual - Pub. 100-03
Medicare Secondary Payer
Fraud & Abuse
- Beneficiary Complaint Response Program
- Physician Self Referral
How to Stay Informed
- Join the mailing list (or listserv). Scroll to the right side of the page to Subscribe.
- Home Health, Hospice & Durable Medical Equipment Open Door Forum
- : CMS Media Release Search