Medicare Hospice Rate for 2013

CMS has published the Medicare Hospice Payment Rates for 2013.  This represents a 1.6% increase in payments for FY 2013.  This rate is comprised of a 2.6% market basket increase; less a 0.7% productivity adjustment; less 0.3% additional hospice-specific productivity adjustment to arrive at the 1.6% rate increase.  Listed below are the Medicare Hospice Payment Rates for 2013:

Code	Description	National Rate	Wage Component	Non-Wage Component
0651	Routine Home Care	$153.45	$105.44	$48.01
0652	Continuous Home Care Full Rate = 24 hours of Care Hourly Rate = $37.32	$895.56	$615.34	$280.22
0655	Inpatient Respite Care	$158.72	$85.92	$72.80
0656	General Inpatient Care	$682.59	$436.93	$245.66

(Notes these rates must be adjusted by wage index)

Hospice Cap amount for cap year ending October 31, 2013 = $25,377.01

Listed below is the temporary link for the proposed rule.  This link will change once it is published in the federal register.

http://www.ofr.gov/OFRUpload/OFRData/2012-18336_PI.pdf

If you have questions or need additional information please call Richard Dixon at

(321) 473-8561.

Medicare Home Health PPS Rules and Rates for 2013 July 9

CMS has announced the publication of the Proposed PPS Rules and Rates for 2013. There are numerous changes included in this proposed rule. This update will include a summary of the key items in the proposed rule. We will follow up this email for the next few days with details on some of the areas.

Description	Proposed Rate 2013	Current Rate 2012	Increase	Percent Increase
Urban Agency Base Rate*	$2,141.95	$2,138.52	$3.43	0.16%
Rural Agency Base Rate*	$2,206.21	$2,202.68	$3.53	0.16%

 *This must be adjusted by wage index and case mix

Total PPS rates increase by 1.5 percent for inflation and decrease by 1.32 percent for case mix creep. The proposed rule establishes requirements for unannounced, standard and extended surveys of home health agencies. It provides a number of alternative or intermediate sanctions that could be imposed if the home health agencies were out of compliance with Federal regulations. It provides some additional guidance in physician face-to-face encounters. It also provides some guidance in the therapy measurements and assessments. The rule also provides information on quality measures for Hospice quality Reporting Program and data submission.

Medicare Home Health PPS Rules and Rates for 2013 July 10

July 10 - Medicare Home Health PPS Rules and Rates for 2013

CMS has announced the publication of the Proposed PPS Rules and Rates for 2013. There are numerous changes included in this proposed rule. This update will include a summary of the Proposed Rates. We will follow up this email for the next few days with details on some of the areas.

  

More Detail on Proposed Medicare Home Health Payment Rates for 2013

Description	Proposed Rate 2013	Current Rate 2012	Increase	Percent Increase
Urban Agency Base Rate*	$2,141.95	$2,138.52	$3.43	0.16%
Rural Agency Base Rate*	$2,206.21	$2,202.68	$3.53	0.16%

 *This must be adjusted by wage index and case mix

   

Urban LUPA Rates	Proposed Rate 2013	Current Rate 2012	Increase
Skilled Nursing (2)	$114.57	$112.88	$1.69
Physical Therapy (2)	$125.28	$123.43	$1.85
Occupational Therapy (2)	$126.12	$124.26	$1.86
Speech Pathology (2)	$136.13	$134.12	$2.01
Medical Social Services (2)	$183.67	$180.96	$2.71
Home Health Aide (2)	$51.90	$51.13	$0.77
LUPA Add On (2)	$96.04	$94.62	$1.42

Rural LUPA Rates	Proposed Rate 2013	Current Rate 2012	Increase
Skilled Nursing (2)	$118.01	$116.27	$1.74
Physical Therapy (2)	$129.04	$127.13	$1.91
Occupational Therapy (2)	$129.90	$127.99	$1.91
Speech Pathology (2)	$140.21	$138.14	$2.07
Medical Social Services (2)	$189.18	$186.39	$2.79
Home Health Aide (2)	$53.46	$52.66	$0.80
LUPA Add On (2)	$98.92	$97.46	$1.46

(2) These rates must be adjusted by wage Index 

Medical Supply Payment Rates

Urban Payment Severity Level	Points (Scoring)	Relative Weight	Proposed Rate 2013	Current Rate 2012	Increase
1	0	0.2698	$14.59	$14.39	$0.20
2	1 to 14	0.9742	$52.68	$51.95	$0.73
3	15 to 27	2.6712	$144.46	$142.46	$2.00
4	28 to 48	3.9686	$214.62	$211.65	$2.97
5	49 to 98	6.1198	$330.96	$326.37	$4.59
6	99+	10.5254	$569.21	$561.32	$7.89

Please remember that all of the above payment rates will be reduced by 2 percent for home health agencies that do not submit quality data.

CMS also made a change to the labor and non-labor portion of payment rates:

Labor & Non Labor Portion of Payment Rates	New 2013	Old 2012	Variance
Labor Portion	78.535%	77.082%	1.453%
Non Labor Portion	21.465%	22.918%	(1.453%)