CMS Issues Hospice Transmittal Updating Rates, Cap, Wage Index and Pricer for FY2016
September 10, 2015 11:28 AM
On September 4, 2015, the Centers for Medicare & Medicaid Services (CMS) issued Change Request 9301/Transmittal 3345 directing Medicare’s Administrative Contractors (MACs) to apply the new payment rates for fiscal year (FY) 2016, including a single Routine Home Care (RHC) rate for care provided October 1 through December 31, 2015 and the two-tiered payment system for RHC, as well as the Service Intensity Add-on (SIA) beginning January 1, 2016. CR9301 also provides the aggregate cap value for 2015 ($27,382.63) and addresses the blended transitional wage index values to be used during FY2016, including identification of core-based statistical areas (CBSAs) for which a special 50xxx code must be used in billing during the wage index transition year. A MLN Matters article (MM9301) related to CR9301 is available here.
This is the second CR released pertaining to the FY2016 hospice final rule. The first CR pertaining to the final rule is CR 9201 (see full coverage in the NAHC Report of August 21, 2015 at http://www.nahc.org/NAHCReport/nr150820_2/.