Hospice Rate Listings
Myers and Stauffer, LC, is the long-term care rate-setting
contractor that sets the Indiana Health Coverage Programs (IHCP)
rates for nursing facilities, hospices, home health agencies, and
group homes. Hospice providers can obtain current rate information
for a particular nursing facility by accessing the Myers and Stauffer's long-term care
Web site and using the following steps:
- Click Long Term Care located on the left.
- Click Nursing Facility.
- Click the Other Reports folder for a list of
- From the list of reports, click Cumulative Rate
- You will be presented with a report listing Medicaid rates for
all Medicaid-certified nursing facilities. Medicaid rates are
updated within 24 hours of finalization.
Enrollment statistics historically reflect that the majority of
individuals enrolled in the IHCP hospice benefit reside in nursing
facilities. The annual hospice rates are effective October 1 of
each year through September 30 of the following year, and are
listed in BT200938.
Weekly enrollment in the IHCP hospice benefit reflects that
75-80 percent of individuals enrolled in the IHCP hospice benefit
reside in nursing facilities. The majority of these individuals
residing in nursing facilities are dually eligible Medicare/IHCP
hospice members for whom Medicare pays for hospice services and for
whom the IHCP pays for room and board under the IHCP hospice
benefit, as outlined in 405 IAC 1-16-4. For
IHCP-only members residing in nursing facilities, the IHCP pays the
hospice provider the hospice per diem, and the room and board
add-on, as outlined in 405 IAC 1-16-4.
Hospice providers are paid 95 percent of the nursing facility
case-mix rate on file when billing the IHCP for room and board
under the hospice benefit using hospice revenue codes 653, 654, and
659. The IHCP pays the hospice provider 95 precent of the lowest
nursing facility rate, so the hospice provider may reimburse the
nursing facility according to their contract.
Hospice Contracts with Nursing Homes
See Section 9 of the IHCP Hospice Provider
Manual for more information regarding hospice care in nursing
Hospice and nursing facility providers are strongly encouraged
to review their contracts on an annual basis and should have their
respective attorneys review Chapter
14, Section 9, of the IHCP Provider Manual to ensure current
contracts are in compliance with the Centers for Medicare &
Medicaid Services' (CMS') requirements.