The Centers for Medicare and Medicaid Services (CMS) establishes payment amounts for four specific categories of covered hospice care: routine home care, continuous home care, inpatient respite care, and general inpatient care.
CMS determines base rates. Payment amounts for routine home care and continuous home care are based upon the CBSA (Core-Based Statistical Area) where the service was furnished. For dates of service through 12/31/07, payment amounts for general inpatient care and inpatient respite care were based upon the CBSA where the hospice provider was located, and were identified for each provider on the Provider Information Sheet. For dates of service beginning 1/1/08, payment amounts for general inpatient and inpatient respite care are based upon the geographic location (CBSA) where the service is furnished.
Each CBSA is assigned a wage index that reflects local geographical differences in wage levels. Payment is determined when the wage index is added to the payment calculation for each service. The listing of CBSAs and corresponding wage indices is published annually in the Federal Register. The Department posts the CBSAs pertinent to Illinois, with current rate information, at the links below.