CMS Posts FY 2025 Hospice Final Payment Rule
(Aug. 6, 2024) On July 30th, the Centers for Medicare and Medicaid Services (CMS) released the Fiscal Year (FY) 2025 Hospice Wage Index final payment rule. The final rule adopts a market basket update of 2.9 percent instead of the originally proposed 2.6 percent. LeadingAge's members-only article on the rule is here, but is not exhaustive and will be updated. A comprehensive CMS Fact Sheet on the final rule is available here.
LeadingAge issued a press release on July 30th that includes comments on the increase and other aspects of the rule from President and CEO Katie Smith Sloan. LeadingAge will convene members at the Aug. 13th meeting of its Hospice Member Network to discuss the final rule. Join the Network here.
CMS finalized proposed changes to the Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS), including removal of and changes to several survey items as well as changes to administration timelines and modes of survey delivery. CMS delayed the final Hospice CAHPS implementation date from Jan. 1, 2025 to April 1, 2025. The link to the final rule is here, and LeadingAge's comments on the proposed rule are here. Other changes include the following:
- The updated market basket update is 2.9 percent instead of the originally proposed 2.6 percent. Payments are impacted by the geographical location of the patient. The wage index applicable to FY 2024 payments is located here.
- Hospices that fail to meet hospice quality reporting requirements will have payments reduced by 4 percent. Currently, the payment reduction is 2 percent.
- The aggregate payment limitation (CAP) for the 2024 CAP Year (Oct. 1, 2023 through Sept. 30, 2024) is $33,494.01.
- CMS codified the Hospice Quality Reporting Program (HQRP) data completion threshold policy at §418.312 and provided several updates relative to the development of a patient assessment instrument, titled Hospice Outcomes and Patient Evaluation (HOPE), and future quality measures. The HOPE tool includes several domains that are new or expanded compared to the Hospice Item Set (HIS), including sociodemographic, diagnoses, symptoms, skin conditions, and imminent death.
- Effective May 1, 2024, physicians certifying the patient as terminally ill must be enrolled in the Medicare program or have a valid opt-out affidavit on file with a Part A and Part B Medicare Administrative Contractor.
- The provision of telehealth services for purposes of routine home care visits and the face-to-face encounter relating to recertification were finalized to extend through Dec. 31, 2024.
The following reflect the final 2024 hospice payment rates, before any geographical adjustment application:
- Routine Home Care (days 1-60) $218.33
- Routine Home Care (days 61+) $172.35
- Continuous Home Care $65.23 per hour
- Inpatient Respite Care $507.71
- General Inpatient Care $1,145.31
Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871