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User Guide for Hospice Quality Reporting Data Collection - cms

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The document is a User Guide for the Hospice Quality Reporting Program, detailing data collection and reporting requirements for hospice providers. It outlines the reporting cycle from October 1, 2012, to April 1, 2013, emphasizing the need for compliance to avoid payment reductions in FY 2014. The guide specifies two key measures: a structural measure related to Quality Assessment and Performance Improvement (QAPI) programs and the NQF #0209 Pain Measure, which assesses pain management effectiveness within 48 hours of patient admission. It provides instructions on data collection processes, submission deadlines, and resources for assistance.

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What is the QAPI program for hospice?

QAPI programs emphasize data-driven decision-making and continuous improvement. By analyzing clinical data and patient feedback, hospices can identify trends, areas for improvement, and best practices.

What is the 5 day rule for hospice patients?

The hospice interdisciplinary team (IDT) has 5 calendar days from the effective date of the hospice election statement to complete the comprehensive assessment. CMS does not dictate how the comprehensive assessment is completed or what forms a hospice provider utilizes to document the comprehensive assessment.

How do I bill Medicare for a hospice patient?

Hospice providers must use revenue code 0657 when billing for pain- and symptom-management services related to a recipients terminal condition and provided by a physician employed by, or under arrangement made by, the hospice. Revenue code 0657 should be billed on a separate line for each date of service.

What are the four measures within the hospice quality reporting program?

The HQRP currently consists of four different quality measures: Hospice Care Index (HCI), Hospice Visits in the Last Days of Life (HVLDL), Hospice Item Set (HIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS).

Does Medicare pay for 100% of hospice care?

Once you start getting hospice care, Original Medicare will cover everything you need related to your terminal illness, even if you choose to stay in a Medicare Advantage Plan or other Medicare health plan.