Hospice Rate Calculator

Hospice rates are updated in accordance with Section 1814(i)(I)(C)(ii) of the Social Security Act and are effective for the period October 1 through September 30 each year. The Centers for Medicare and Medicaid Services (CMS) notifies intermediaries through a Program Memorandum of the hospice rates for the coming year. The rates are adjusted using the Hospice Wage Index to reflect local differences in wage levels. The hospice wage indices are published by CMS in the Federal Register before October 1 each year.

To assist hospices in obtaining their current hospice rates, we are providing a Hospice Rate Calculator which is available for every state. For claims where the dates of service span separate fiscal years, separate bills are recommended. Claims that are not split by the hospice will not be adjusted by the intermediary to reflect the change. Payments for hospice physician services are not affected by this provision.

All payment rates, including Inpatient Respite and General Inpatient Services are reimbursed based upon the location of where the hospice services were provided. Hospice claims will use the value code G8 to indicate the CBSA location where the inpatient care is provided.

Rate Calculator

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