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Updated Reimbursement Rates for Routine Home Care

June 14, 2016

Reimbursement rates have been updated through CMS–1629–F, Medicare Program; FY 2016 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements for routine home care. Updates are based on the recipient’s length of stay. A service intensity add-on (SIA) payment has also been implemented for services provided by a registered nurse or social worker in the last seven days of a recipient’s life for at least 15 minutes and up to four hours total per day.

The Department of Health Care Services (DHCS) is developing a solution for reimbursing providers according to the new requirements. The Hospice Care Web page of the DHCS website includes updated reimbursement rates in anticipation of DHCS’ ability to reimburse in accordance with the new rate requirements. However, current reimbursement rates effective from October 1, 2015, to December 31, 2015, will remain in place until further notice.