September 20, 2022
Beginning October 1, 2022, hospice base payment rates will increase by 3.8 percent, as published in the final FY2023 Hospice Payment Rule. As is customary, the Medicaid program waits until Medicare rates are finalized to issue guidance on the applicable corresponding hospice payment rates.
The TABLE below contains a comparison drawn from these two documents of the FY2023 Medicare and Medicaid rates. The labor portion of these rates must be further adjusted by the wage index. It should be noted that beginning on October 1, 2023, CMS will follow a new policy under which reductions in wage index values from one year to the next will be limited to a drop of 5 percent. The table below contains the new labor shares for the daily payment rates.
Further, effective beginning with FY2024, section 1814(i)(5)(A)(i) of the Social Security Act was amended by the Consolidated Appropriations Act of 2021 (CAA) to increase the payment reduction for Medicare hospices who fail to meet hospice quality measure reporting requirements from 2 percentage points to 4 percentage points. Medicaid minimum rates would be reduced by the amount of any penalty due to non-reporting provided a state has chosen to implement this optional Medicaid hospice rate reduction for lack of quality reporting and imposition of the penalty as well as the penalty percentage has been specified in the Medicaid state plan.
The hospice Aggregate Cap for the year ending September 30, 2023, is $32,486.92.
FY 2023 Medicare Hospice Payment Rates under MEDICARE and MEDICAID*
Description | Revised Labor Share | FY2023 MEDICARE Payment Rate | FY2023
MEDICAID Payment Rate |
Routine Home Care
(Days 1-60) |
66 percent |
$211.34 |
$211.61 |
Routine Home Care
(Days 61+) |
66 percent |
$167.00 |
$167.22 |
Continuous Home
Care Full Rate = 24 hours |
75.2 percent |
$1,522.04 ($63.42 hourly rate) |
$1,522.63 ($63.44 hourly rate) |
Inpatient Respite
Care |
61 percent |
$492.10 |
$518.00 |
General Inpatient
Care |
63.5 percent |
$1,110.76 |
$1,110.76
|
Source: NAHC
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