CMS to Implement Claim Edit for Hospice Transfers

Effective July 1 2022, a claims processing edit to prevent gap billing between hospice transfers will be implemented. Per Change Request (CR) 12619 Gap Billing Between Hospice Transfers, a patient can change hospices only once per benefit period (60-day or 90-day). When the patient transfers to a different hospice, he or she continues in the same benefit period. To transfer hospice programs, the individual or representative must file, with the hospice from which care has been given and with the newly designated hospice, a statement that includes the following information:

Home Health Payment System Final Rule For Calendar Year 2022

The Centers for Medicare & Medicaid Services (CMS) issued a rule that finalizes a nationwide expansion of the successful Home Health Value-Based Purchasing (HHVBP) Model and makes updates to the Medicare Home Health Prospective Payment System (PPS) and the home infusion therapy services payment rates for Calendar Year (CY) 2022, in accordance with existing statutory and regulatory requirements.

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