2025 Hospice Final Rule Released

The 2025 Hospice Final Rule brings significant changes to Hospice, including rate adjustments, HOPE tool implementation, and more.

RATE ADJUSTMENT

The most significant change in the 2025 Hospice Final Rule is the rate adjustment. Starting October 1, 2024, there will be a net increase of 2.9% in Hospice rates. Additionally, the Hospice cap amount has been finalized to align with this 2.9% annual payment update, setting the cap at $34,464.34.

RECLASSIFICATION OF COUNTIES

They have also finalized changes involving the reclassification of certain counties from one CBSA to another, including shifts from urban to rural areas and vice versa. These changes in the wage index and CBSA designations have led to some challenges in billing. While these aren’t technically issues, they do require clarifications that will need to be applied to your claims starting in October. We will provide a detailed Monday Minute session to discuss the wage index situation and guide you on how to manage your claims beginning in October.

HOPE TOOL

They have finalized the implementation of the HOPE tool, which means we’ll start using this new clinical assessment tool on October 1, 2025. This gives us a year to prepare, and HPS will offer numerous educational opportunities to help you become familiar with the HOPE tool as we approach the deadline.

For a more detailed look at information contained within the Hospice Final Rule regarding the HOPE tool, click here.

QUALITY PROCESS MEASURES

The implementation of the HOPE tool will also introduce two new quality process measures: the Timely Reassessment of Non-Pain Symptom Impact and the Timely Reassessment of Pain Impact. These measures are expected to be publicly reported starting no earlier than November 2027, as they will be derived from the HOPE tool, which will be introduced in 2025.

HOSPICE SURVEY

The Hospice survey has undergone several changes, with both proposed and finalized updates. Starting in April 2025, a web-based email version of the Hospice survey will be introduced.

ELECTION STATEMENT/NOTICE OF ELECTION

They have clarified some regulatory language concerning the Election Statement and the Notice of Election. It has been quite confusing because some contractors have mistakenly referred to the Notice of Election as the actual Election Statement that the patient signs, while in reality, the Notice of Election is a billing element. Clear changes needed to be made in this area. Additionally, they had several requests for information in the proposed rule and received numerous comments, for which CMS expressed appreciation in the Final Rule.

The final rule introduces several changes to Hospice, some of which will be implemented in October, while others will roll out over the next year. HPS will keep you updated on these developments and provide education as needed. Should you require assistance with any of hospice needs, please feel free to reach out to us.

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