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TRICARE Reimbursement Manual 6010.61-M, April 1, 2015
Hospice
Chapter 11
Addendum A (FY 2020)
Hospice Care Rates - FY 2020
Revision:  C-44, December 13, 2019
The payment rates were increased by the market basket update of 2.6%.
Effective January 1, 2016, two separate payment rates will be applicable for Routine Home Care (RHC). A higher RHC rate for days 1 through 60, and a lower RHC rate for days 61 and beyond of a hospice episode of care, will replace the single rate.
The following national hospice rates are for care and services provided on or after October 1, 2019, through September 30, 2020. The hospice rates applicable to the above period are:
Revenue Code
Description
FY 2020 Payment Rate
Labor Share
Non-Labor share
0651
RHC (days 1-60)
$194.50
$133.64
$60.86
0651
RHC (days 61+)
$153.72
$105.62
$48.10
0652
Continuous Home Care (CHC) Full Rate = 24 hours of care = $58.15 FY 2020 hourly rate
$1,395.63
$958.94
$436.69
0655
Inpatient Respite Care (IRC)
$450.10
$243.64
$206.46
0656
General Inpatient Care (GIP)
$1,021.25
$653.70
$367.55
Allow the provider to split bills if they span the effective date. Use the previous year’s rates if the provider chooses not to split the bill.
Hospice Cap Amount
The hospice cap amount for the 2020 cap year is $29,964.78.
Note:  Significant increases in the FY2020 CHC, IRC, and GIP payment rates and slight decreases in the RHC payment rates are the result of the Centers for Medicare & Medicaid Services final rule (84 FR 38484) which rebased the hospice payment rates in a budget neutral manner to more accurately align Medicare payments with the costs of providing care. For further information, the final rule may be found at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/Hospice/Hospice-Regulations-and-Notices.html.
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