Hospice Center

Content Section

Spotlights

Physician consultation codes no longer valid for Medicare: In December 2009, CMS issued CR6740 [PDF 244KB] instructing that as of January 1, 2010, CPT consultation codes 99241-99245 and 99251-99255 are no longer valid for Medicare Part B billing. Because this affects Part A billing, as well, CMS will be issuing a separate CR to address Part A billing as it relates to these services. In the interim, hospices should look to CR6740 [PDF 244KB] for instructions (excluding those related to the use of an "AI" modifier) as to how to bill for these services.
CMS has revised hospice-related Q&A #9970, regarding the reporting of social worker phone calls (posted 2/19/10)
There are several new Q&As posted, dealing with physician narratives, charges on claims, and social worker calls. Please go to the "How to Stay Informed" section of this page and click on "Questions and Answers: Hospice".
CR6540 [PDF, 156.34 KB] – Hospice Reporting Requirements for the Attending Physician and the Hospice Physician Certifying the Terminal Illness. This Change Request (Transmittal 1885) rescinds and replaces Transmittal 1870 (dated 12/11/09) to allow the revised reporting instructions to be optional beginning January 1, 2010 and required for claims with dates of service on or after April 1, 2010. All other material remains the same (issued 12/23/09).
The FY 2010 Hospice Wage Index is now available in Excel and text (508 compliant) file formats. (posted 12/18/09)
Updated hospice statistics are now available for calendar years 1998 to 2008, and include the 20 most frequent diagnoses, the number of patients, average length of stay, and trends over time in length of stay, by diagnosis. (posted 10/30/09)
CR 6606 - Update to the Hospice Payment Rates, Hospice Cap, Hospice Wage Index, and the Hospice Pricer for FY 2010 (issued 8/14/09)
CMS-1420-F (Publication Date: August 6, 2009): The Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare Hospice Wage Index for fiscal year (FY) 2010. This rule revises the phase-out of the hospice wage index budget neutrality adjustment factor (BNAF), which was finalized in the FY 2009 final rule, to now occur over 7 years. As a result of this final rule, the BNAF will be reduced by 10 percent in FY 2010, and 15 percent each year from FY 2011 through FY 2016. The combined effects of a 10% reduction to the BNAF in the FY 2010 Hospice Wage Index and a 2.1% hospital market basket update are estimated to increase payment to hospices in FY 2010 by 1.4 percent. In addition, this final requires hospice physicians to provide a short narrative as part of hospice certifications and recertifications of terminal illness.
Update to Aggregate Cap Amount [PDF, 20KB]: The 2009 hospice aggregate cap amount is $23, 014.50.