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March 6, 2015 - Revised: 01.14.16

Hospice Self-Determined Aggregate Cap

The Centers for Medicare & Medicaid Services (CMS) published the fiscal year (FY) 2015 Hospice Wage Index and Payment Rate Update final rule on August 22, 2014. The final rule included a requirement for hospices to file a self–determined hospice aggregate cap. Hospices are required to file the self-determined cap each year, between January 31 and March 31.

As a reminder, the Hospice Caps Web page was created on the CGS website to assist hospices with this process. This Web page includes a link to the "Provider Self-Determined Aggregate Cap Limitation" form, as well as instructions for completing the form.

Hospices are responsible for obtaining their own Provider Statistical and Reimbursement (PS&R) summary from the CMS websiteExternal Website. CGS will not provide this to hospices. An instruction for obtaining your PS&R reports is also available from the Hospice Caps Web page. If a hospice is unable to obtain a copy of their PS&R reports, please contact Tom Bisbee at CGS, at 615-660-5560 for assistance.

Refer to the Hospice Caps Web page for more detailed information about this process and links to additional resources.

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