Posted February 15, 2023
Hospice providers are required to self-calculate and submit their Aggregate Cap Report for the 2022 Cap year no later than February 28, 2023. Failure to file the self-determined cap report with your Medicare Administrative Contractor (MAC) timely may result in payment suspension. If you have a Cap-related liability, you are required to submit payment at the time you submit your report.
In order to calculate the Cap, you must be able to access your hospice’s PS&R data, so if you do not have access to CMS’ Identify Management System (formerly EIDM), through which the PS&R data is available) it is advisable that you take action immediately to ensure timely access so that you can meet the reporting deadline. The hospice aggregate cap value for 2022 is $31,297.61.
All three MACs for Home Health and Hospice have online instructions for self-calculation and submission of the Cap report; the information is available at the following locations:
Palmetto GBA
Recent postings to the Palmetto GBA website about the aggregate cap report are available HERE and HERE.
Palmetto serves Home Health and Hospice providers in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, and Texas.
CGS
Recent CGS online postings about the aggregate cap report are available HERE and HERE.
CGS serves Home Health and Hospice providers in Colorado, Delaware, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, South Dakota, Pennsylvania, Utah, Virginia, West Virginia, Wyoming, and the District of Columbia.
NGS
NGS has not yet updated its Hospice Cap self-calculation guidance; guidance for the 2021 cap year is available HERE. The form is available in the NGS FORMS section.
NGS has two Home Health and Hospice Jurisdictions (JK and J6) and serves providers in the following states: Alaska, American Samoa, Arizona, California, Connecticut, Guam, Hawaii, Idaho, Maine, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New York, Northern Mariana Islands, Oregon, Puerto Rico, Rhode Island, US Virgin Islands, Vermont, Wisconsin, and Washington.
Source: NAHC
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