The 2020 Hospice Final Rule was published in the Federal Register August 6, 2019, and will affect hospital discharges on or after October 1, 2019. Each year, CMS publishes updates to the regulations for inflation factors, wage adjustments, etc. For FY 2020, CMS has updated the following Hospice rates which are contained in the final rule:
Hospice Payments where Quality Standards are met:
|
Code/Description |
FY 2019 Final Rule |
FY 2020 Proposed Rule |
FY 2020 Final Rule |
Percent Change From 2019 vs. 2020 |
|
651 – Routine Home Care day 1-60 |
$196.25 |
$195.65 |
$194.50 |
-0.892% |
|
651 – Routine Home Care day 61+ |
$154.21 |
$154.63 |
$153.72 |
-0.318% |
|
652 – Continuous Home Care (CHC) |
$997.38 |
$1,405.81 |
$1,395.63 |
39.93% |
|
655 – Inpatient Respite Care (IRC) |
$176.01 |
$449.78 |
$450.10 |
155.72% |
|
656 – General Inpatient Care (GIC) |
$758.07 |
$1,027.43 |
$1,021.25 |
34.72% |
Hospice Payments where Quality Standards are not met:
|
Code/Description |
FY 2019 Final Rule |
FY 2020 Proposed Rule |
FY 2020 Final Rule |
Percent Change 2019 vs. 2020 |
|
651 – Routine Home Care day 1-60 |
$192.39 |
$191.84 |
$190.71 |
-0.873% |
|
651 – Routine Home Care day 61+ |
$151.18 |
$151.62 |
$150.72 |
-0.304% |
|
652 – Continuous Home Care (CHC) |
$977.78 |
$1,378.43 |
$1,368.42 |
39.95% |
|
655 – Inpatient Respite Care (IRC) |
$172.56 |
$441.02 |
$441.32 |
155.75% |
|
656 – General Inpatient Care (GIC) |
$743.18 |
$1,007.42 |
$1,001.35 |
34.74% |
Per the recently issued CMS MLN Matters Article MM11411,
“The FY 2020 RHC per diem payment rates are the FY 2019 REBASED payment rates, reduced by a budget neutrality factor as a result of rebasing of the Continuous Home Care (CHC), Inpatient Respite Care (IRC), and General Inpatient Care (GIP) payment amounts, adjusted by the Service Intensity Add-On (SIA) budget neutrality factor, adjusted by the wage index standardization factor, and increased by the 2.6 percent hospice payment update percentage. The FY 2020 rebased CHC, IRC, and GIP per diem payment rates are equal to the FY 2019 rebased payment rates, adjusted by the wage index standardization factor and increased by the hospice payment update percentage (2.6 percent).”
Download the MLN Matters article here.
The reason for the rebasing was to bring the rates to a more current depiction of the cost/payment amounts for Hospice patients. The rates previous to the FY 2019 rebasing were based on 1983 base rates that have been updated over the subsequent years using information from a relatively small set of 26 hospices that were participating in a CMS hospice demonstration.
Other notable items from our recent review of the finalized Hospice rule include:
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The finalized hospice cap amount for FY 2020 will be $29,964.78, which increased from $29,205.44.
-
CMS finalized as proposed, to use the same pre-reclassified, pre-floor hospital wage index from the current year as the hospice wage index. This would base the hospice wage index on the FY 2020 IPPS hospital wage index, pre-floor and pre-reclassified.
The Federal Register version of the Hospice Final Rule can be viewed here.
Brush up on additional final rules that were published for 2020 including:
