CMS Issues Medicaid Hospice Rates for FY2014

September 13, 2013 08:52 AM

In an August 30, 2013 Memorandum to Associate Regional Administrators in the Division of Medicaid, the Centers for Medicare & Medicaid Services (CMS) issued payment rates that will govern reimbursement for Medicaid hospice services during Fiscal Year (FY) 2014. As with the Medicare rates for FY2014 issued previously, the Memorandum outlines one set of rates applicable to hospices that met quality data submission requirements of the Hospice Quality Reporting Program (HQRP) and another for those hospices that failed to submit the required quality data.

Following are the rates that will be applicable for the fiscal year beginning October 1, 2013:

Table 1: FY2014 Hospice MEDICAID Payment Rates for Hospice Providers that Have Submitted the Required Quality Data

DESCRIPTION	DAILY RATE	WAGE COMPONENT SUBJECT TO INDEX	NON-WEIGHTED AMOUNT
Routine Home Care	$156.26	$107.37	$48.89
Continuous Home Care	$911.14 full rate=24 hours of care/$37.96 hourly rate	$626.05	$285.09
Inpatient Respite Care	$169.92	$91.98	$77.94
General Inpatient Care	$694.19	$444.35	$249.84

Table 2: FY2014 Hospice MEDICAID Payment Rates for Hospice Providers that Have NOT Submitted the Required Quality Data

DESCRIPTION	DAILY RATE	WAGE COMPONENT SUBJECT TO INDEX	NON-WEIGHTED AMOUNT
Routine Home Care	$153.19	$105.26	$47.93
Continuous Home Care	$893.22 full rate=24 hours of care/$37.22 hourly rate	$613.73	$279.49
Inpatient Respite Care	$166.57	$90.17	$76.40
General Inpatient Care	$680.54	$435.61	$244.93

The formula to apply to determine the hospice rates for a local geographic region is: Geographic Factor (from the Medicare wage index) x Wage Component Subject to Index + Non-weighted Amount.

The Medicare wage index values for FY2014 are available on CMS’ Hospice Center web page, under Wage Index Files.

Below are the FY2014 Medicare Hospice Payment Rates for comparison.

Table 3: FY2014 MEDICARE Hospice Payment Rates Updated by the estimated Hospice Payment Update Percentage

Code	Description	FY2014 final Payment Rate	Labor Share of the final payment rate	Non-Labor share of the final payment rate
651	Routine Home Care	$156.06	$107.23	$48.83
652	Continuous Home Care Full Rate = 24 hours of care $=37.95 hourly rate	$910.78	$625.80	$284.98
655	Inpatient Respite Care	$161.42	$87.38	$74.04
656	General Inpatient Care	$694.19	$444.35	$249.84

Table 4: MEDICARE Hospice Payment Update Percentage for Hospices That DO NOT Submit the Required Quality Data

Code	Description	FY2014 final Payment Rate	Labor Share of the final payment rate	Non-Labor share of the final payment rate
651	Routine Home Care	$152.99	$105.12	$47.87
652	Continuous Home Care full Rate=24 hours of care $=37.20 hourly rate	$892.87	$613.49	$279.38
655	Inpatient Respite Care	$158.24	$85.66	$72.58
656	General Inpatient Care	$680.54	$435.61	$244.93

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