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Flat Hospice Per-Diem Rate Replaced 1/1/16

January 04, 2016

A recent hospice update Eliminates the 3-Decade Old Per-Diem Rate:

  1. Hospices will now be reimbursed a rate that is higher on days 1-60 of a stay ($187.54) and lower thereafter ($145.14).  
  2. Hospices can now bill for reimbursement for service intensity add-on (SIA) payments which pay agencies for up to four hours of direct patient care from a registered nurse or social worker (at $38.75/hour) provided to enrollees during their last seven days of life.

In replacing the flat per-diem rate, CMS sought to align payments more closely with agency costs over the course of hospice enrollees’ stays

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