A move to help ease provider burden with the new wage index designations will also complicate billing this year. The Centers for Medicare & Medicaid Services is adopting new Office of Management and Budget categories for wage index areas, and is capping any changes in value at 5 percent in fiscal year 2021 (see HCW by AAPC, Vol. XXIX, No. 29). The problem: Due the transition methodology, “some Core Based Statistical Areas (CBSAs) and statewide rural areas will have more than one wage index value associated with that CBSA or rural area,” CMS says in Aug. 27 Change Request 11876. “However, each county will have only one wage index value. For counties that correspond to a different transition wage index value, the CBSA number will not be able to be used for FY 2021 claims.” Solution: “In these cases, a number other than the CBSA number will be needed to identify the appropriate wage index value for claims for hospice care provided in FY 2021,” CMS explains. “These numbers are five digits in length and begin with ’50.’” HHH Medicare Administrative Contractor CGS has listed the alternate CBSA codes at www.cgsmedicare.com/hhh/pubs/news/2020/09/cope18826.html.