Electronically Filing Your 2020 Hospice Cap Report

Thoughtware Alert Published: Feb 09, 2021
Stethoscope and laptop

If you haven’t yet filed your 2020 hospice self-determined aggregate cap report, there are a few things you should know. First, the due date is right around the corner—no later than March 1, 2021. Provider Statistical and Reimbursement (PS&R) summary reports should be run to reflect the federal fiscal year October 1 through September 30. Likewise, beneficiary summary reports also should be run for the federal fiscal year, regardless of the beneficiary method used (streamlined or proportional). Keep in mind, though, the earliest date these reports can be run is January 1, 2021, to be accepted by Medicare. The cap amount for the 2020 cap year is $29,964.78 per beneficiary, and any providers exceeding the aggregate cap will look to their corresponding Medicare Administrative Contractor (MAC) for a demand for repayment based on the unique review timelines of each MAC. If necessary, providers may request for an extended repayment plan.

Medicare requires a full year of coverage for cap reporting. Therefore, newly certified hospice agencies that started during the 2020 cap year will need to file a self-determined aggregate cap report in 2022 using a weighted-average computation for the 2020 and 2021 cap years for the months in each cap year since the provider’s inception. This would apply to any providers certified after October 1, 2019.

Providers are required to obtain the PS&R net reimbursement amount and beneficiary counts information directly through the Enterprise Identity Management (EIDM) system. If your agency needs to establish EIDM and PS&R access, be sure to register now.

Previously, the hospice self-determined cap report was required to be paper filed with the applicable MAC; however, all MACs are now accepting email submissions of the reports. 

If emailing your hospice self-determined cap report, see below for the submission email address to be used for each of the MACs.

If you have questions or would like assistance preparing your hospice self-determined aggregate cap report, reach out to your BKD Trusted Advisor™ or submit the Contact Us form below.

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