CMS Issues FY13 Hospice Payment Rates, Hospice Software Can Help

CMS Issues FY2013 Hospice Payment Rates, Hospice Software can Help

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 7857/Transmittal 2497, providing information on fiscal year (FY) 2013 payment rates for the hospice levels of care, the FY2013 hospice payment update, and the hospice aggregate cap amount for the period Nov. 1, 2011, through Oct. 31, 2012.


For FY2013, hospice payment rates will increase, on average, 1.6 percent over payments for FY2012. This value was calculated using the final hospital market basket update for FY2013 (2.6 percent) minus a productivity adjustment of 0.7 percentage point and also minus a 0.3 percentage point (the productivity adjustment and the additional 0.3 percentage point reduction were mandated by the Affordable Care Act).

PLEASE NOTE: the 1.6 percent increase in payment rates does NOT reflect the impact of the continuing phase out of the budget neutrality adjustment factor to the hospice wage index, which should have an additional negative impact of approximately 0.6 percentage points overall. Additionally, the 1.6 percent increase does not reflect any impact of the budget deficit sequester – it is, as yet, unclear whether Congress will act to blunt the sequester scheduled for January 2013. If Congress fails to act, the sequester would have an impact of an additional 2 percentage point reduction in payments.

Following are the payment rates for the four levels of care for FY2013:

  • Code 0651 for Routine Homecare rate is $153.45
  • Code 0652 for Continuous Homecare rate is $895.56
  • Code 0655 for Inpatient Respite Care rate is $158.72
  • Code 0656 for General Inpatient Care rate is $682.59


The aggregate hospice cap amount for the cap year ending October 31, 2012 is $25,377.01.


Hospice wage index value tables for FY2013 are expected to be made publicly available at any time.

Source is from the National Association of Homecare NAHC Report.

Hospice software can assist you to manage the payment reimbursement rates to automatically adjust to the upcoming payment rates for hospice providers. Automating and keeping up to date with new payment rates and regulatory standards is essential for compliance and business health.