Eli's Hospice Insider

Published on Thu May 17, 2018 PDF

Chalk up the change to regulatory relief.

Medicare plans to give hospices a helping hand when it comes to identifying "high" or "low" Routine Home Care payment dates, starting Oct. 1.

The problem: "Hospice providers have told the Centers for Medicare & Medicare Services ... of the difficulties of determining which RHC days were paid at the high or low rate; and are looking for ways to make high versus low RHC payments more transparent," CMS notes in MLN Matters article MM10573.

The solution: The claims system will "add value codes to the claim that display the number of days paid at both the high and low RHC payment rates," CMS says.

Medicare will create fields that display days for value code 62 (Number of High RHC days that fall within the first 60 days of an RHC hospice claim) and value code 63 (Number of Low RHC days that come after the first 60 days of an RHC hospice claim), CMS says.

The system also will "add a separate field on the claim record that will store any days from a prior period that were used in determining the count of days," according to CR 10573. "This data is currently used in processing but is not stored for future reference."

CMS implemented the new requirement in the same transmittal in which it gives hospices relief on reporting drug costs (see story, p. 46).