Home Health & Hospice Week

Check out the wage index winners and losers for 2023.

If you’re wondering how much a proposed cap on hospice wage index decreases would affect the reimbursement picture, the 2023 wage index figures can give you an idea.

Recap: In the hospice 2023 payment proposed rule published in the April 4 Federal Register, the Centers for Medicare & Medicaid proposes “for FY 2023 and subsequent years … to apply a permanent 5-percent cap on any decrease to a geographic area’s wage index from its wage index in the prior year, regardless of the circumstances causing the decline” (see HCW by AAPC, Vol. XXXI, No. 12).

According to analysis by CPA Dave Macke of VonLehman & Co. of the proposed hospice wage index that accompanies the rule, no rural areas would hit the negative 5 percent threshold for the cap. However, two CBSA areas would by just a smidge.

Yauco, Puerto Rico (CBSA code 49500) is projected to decrease 5.01 percent to 0.3777, and Mayaguez, Puerto Rico (CBSA code 32420) is project to decrease 5.01 percent to 0.4004. Those would be capped at 5 percent even instead.

However: Many hospices and their representatives continue to lobby for a cap on even smaller decreases down to 3 percent. That request is expected to feature in a number of comment letters submitted on the proposed rule.

If CMS would adopt a cap on wage index decreases of 3 percent or more, that would affect the rural index for five states — Washington (projected 3.71 percent decrease in 2023), Utah (-4.12 percent), Wisconsin (-4.15 percent), North Dakota (-5.00 percent), and Montana (-5.00 percent), according to the analysis Macke has shared with AAPC.

Further, lowering the cap threshold to 3 percent would reduce decreases for 38 urban CBSAs, including 12 areas with decreases right at 5.00 percent ranging from California to Virginia.