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Hospice Cap Reports

The Fiscal Year (FY) 2015 Hospice Wage Index and Payment Rate Update requires hospices to file a self-determined hospice aggregate cap.

The latest the self-determined cap can be filed is March 31 of each year. 

There is a “Provider Self-Determined Aggregate Cap Limitation” form that must be completed by the hospice.  Instructions for completing this form can be accessed from the CGS website.

Hospices are responsible for obtaining their own Provider Statistical and Reimbursement (PS&R) summary from the CMS website.  Instructions for obtaining your PS&R report is also available from the CGS ‘Hospice Cap’ Web page.

If a hospice does not know which method is being used for their agency, the streamlined or proportional method, hospices can review their prior year Hospice Cap Report, which contains the method in the title of the report.

For more information about the Hospice Cap, refer to the CGS ‘Hospice Cap’ Web page.

CY 2015 Home Health Prospective Payment System Final Rule

The CY 2015 Home Health Prospective Payment System final rule finalized a new patient certification requirement for home health agencies beginning January 1, 2015. Access the Centers for Medicare & Medicaid Services (CMS) MLN Connects™ National Provider Call information for discussion about the changes to the Medicare home health benefit with CMS subject matter experts, followed by a question and answer session. Once CMS issues formal instructions to CGS, via the form of a Change Request, information on the CGS website will be updated, and provider-wide education will be done.

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