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CMS Finalizes Updates to the Wage Index and Payment Rates for Hospice Benefits for FY2019

Posted on Friday, August 3, 2018 5:32 PM

On August 1, 2019, CMS issued its final rule for FY 2019 for Medicare payment rates and the wage index for hospices that serve Medicare beneficiaries.  In this rule, they also update the hospice quality reporting requirements.

Under existing law, the hospice update percentage for FY2019 is calculated using the hospital market basket update of 2.9 percent and reducing it by Affordable Care Act (ACA)-enacted adjustments (a productivity adjustment for FY2019 calculated at 0.8 percentage point and an additional 0.3 percentage point reduction specific to hospice providers).  Taking these factors into consideration, the hospice payment update for FY2019 has been finalized at 1.8 percent.

The following is chart from NAHC shows the final payment rates for FY 2019:

Code

Description

FY2019 Proposed Payment Rates

FY2019 Final Rates

651

RHC (Routine Home Care)

Tier 1 (days 1 – 60)

$196.25

$196.25

651

RHC Tier 2 (days 61+)

$154.21

$154.21

652

CHC (Continuous Home Care)

(full rate=24 hours of care)

 

$998.77

($41.62 hourly rate)

$997.38

($41.56 hourly rate)

655

IRC (Inpatient Respite)

$176.01

$176.01

656

GIP (General Inpatient)

$758.07

$758.07

 The following table provides the breakdown of the labor and non-labor adjusted portions of the payment rates (these have remained the same for several years):

 

LABOR

NON-LABOR

RHC

68.71

31.29

CHC

68.71

31.29

GIP

64.01

35.99

IRC (Respite)

54.13

45.87

 

Also, the new rule finalizes the long-anticipated change to allow Physician Assistants (PA) to serve as Attending Physicians.  For this purpose, a PA is a professional who has graduated from an accredited physician assistant educational program who performs such services as he or she is legally authorized to perform… in accordance with state law…and who meets the training, education, and experience requirements as the Secretary may prescribe.

Click here for the press release.


About Corridor

Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!

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