Hospice

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:

  1. Click Long Term Care located on the left.
  2. Click Nursing Facility.
  3. Click the Other Reports folder for a list of available reports.
  4. From the list of reports, click Cumulative Rate Listing.
  5. 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 facilities.

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.