CMS Changes Rules on Vaccines for Hospice Patients

The Centers for Medicare & Medicaid Services (CMS) recently emphasized policy enforcement on reimbursement windows for respite care and changed its policy on what kinds of care providers can give vaccines to hospice patients.

Respite care, when in-home caregivers are essentially given a short break from their duty, can only be billed to Medicare in five-day increments, says a February 6 CMS Transmittal

“CMS does not construe this as a change to the [Medicare Administrative Contractor] statement of Work,” the agency notes. Rather, the instruction enforces a current policy limiting payment for respite care to no more than five consecutive days.

Reimbursement claims for longer than five days of respite care will get returned to the provider. “Days of respite care beyond five days must be billed at the appropriate home care rate for payment consideration,” the transmittal says. 

Non-hospice providers are now able to provide vaccines to hospice patients, changing a previous restriction in the Medicare manual provision that vaccines would only be covered when furnished by the hospice, CMS said in another transmittal dated February 6.

Starting April 7, any provider can provide vaccines—including flu shots—to hospice beneficiaries. 

Written by Alyssa Gerace