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KMAP BULLETIN: Hospice Payment Rates for FFY 2021

Date: 10/06/20

KMAP GENERAL BULLETIN 20199 (PDF)

Effective with dates of service on and after October 1, 2020, hospice services will be reimbursed in accordance with the Federal Fiscal Year (FFY) 2021 policy. The rates are based on provider compliance with submission of required hospice quality data in accordance with Section 3004 of the Affordable Care Act.

The new rates have been updated in the Hospice Fee-for-Service Provider Manual. T2044 and T2045 must be billed based on the county of the hospice provider. T2043, G0299 U2, and G0155 must be billed based upon the county of the member.

Note: Centers for Medicare and Medicaid Services (CMS) is providing links to updated examples of the hospice election statement and the hospice election statement addendum that reflect the changes finalized in the FY 2020 hospice final rule (84 FR 38520) to assist hospices in understanding the content requirements for the hospice election statement and addendum, effective October 1, 2020. These requirements were finalized to increase coverage transparency for beneficiaries electing the Medicare hospice benefit.

CMS Links:

  • Model Example of Hospice Election Statement
  • Model Example of Patient Notification of Hospice Non-Covered Items, Services, and Drugs

Note: The effective date of the policy is October 1, 2020. The implementation of State policy by the KanCare managed care organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates, once the policy is implemented.