In August, the Center for Medicare and Medicaid Services (CMS) published the 2020 hospice final rule. Included in this ruling are updates for the hospice wage index, payment rates and most importantly – the cap amount. As a result, this 2020 rule rebases payment rates for continuous home care, general inpatient care and inpatient respite care. Overall, CMS gave hospice a 2.6 percent increase, raising the annual cap to $29,964.78.
Medicare acknowledged the payment rates for CHC, GIP and IRC have been lower than the actual cost to provide these levels of care, and plans are in place to align more accurately with care costs by increasing reimbursements. In regards to routine health care, CMS is required to make the change budget neutral and the rates for routine home care are being reduced by 2.72 percent. CHC will increase by 36 percent, IRC will increase by 161 percent, and GIP will increase by 31 percent.
So, what does this mean for your agency? While it appears the rebasing of payments will result in decreased revenue for hospice agencies who don’t provide a significant number of CHS, GIP and IRC care days – Medicare’s calculations don’t reflect a significant reduction for most.
Medicare created a payment impact simulation tool, using actual 2018 utilization data from claims. This tool shows each agency’s routine care actual reimbursement, what the updated reimbursement would be in 2020 with only the 2.6% market basket increase and what the 2020 reimbursement would be with all rebasing calculations applied. The tool can be found at:
If you are concerned about 2020 rebasing and rule’s accompanying updates, the Advanced Hospice Management team is excited to help you through the transition and beyond. We have a superior team of highly-trained and driven professionals with decades of experience in the hospice billing industry. Our focus is solely on filing clean claims, collecting your money quickly and providing accurate hospice billing reports. From billing to claims corrections, appeals, and reconsiderations, we follow every claim until it is paid. To us, it’s more than a job – it’s a commitment.