Fiscal Year (FY)24 Hospice Rate Update, October 1, 2023
Effective October 1, 2023, the Hospice Services Fee Schedule has been updated in MIHMS. See the list below for affected codes and rates.
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Section 43 - Hospice Services Fee Schedule |
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Updated for the time period, October 1, 2023 - September 30, 2024 |
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Procedure Code |
Description |
Androscoggin Rate |
Cumberland Rate |
Penobscot Rate |
Sagadahoc Rate |
York Rate |
Rural Rate* |
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T2042 |
Routine Home Care (per diem) 1-60 days
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$242.63 |
$266.00 |
$254.00 |
$266.00 |
$266.00 |
$238.39 |
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T2042 |
Routine Home Care (per diem) 61+ days |
$191.52 |
$209.97 |
$200.50 |
$209.97 |
$209.97 |
$188.18 |
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T2043 |
Continuous Home Care (hourly) |
$57.98 |
$64.45 |
$61.15 |
$64.45 |
$64.45 |
$56.82 |
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T2044 |
Inpatient Respite Care (per diem) |
$486.18 |
$529.12 |
$507.08 |
$529.12 |
$529.12 |
$478.39 |
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T2045 |
General Inpatient Care (per diem) |
$1,037.67 |
$1,133.46 |
$1,084.29 |
$1,133.46 |
$1,133.46 |
$1,020.29 |
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G0299 |
Service Intensity Add-On (Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes) |
$14.50 |
$16.11 |
$15.29 |
$16.11 |
$16.11 |
$14.20 |
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G0155 |
Service Intensity Add-On (Services of a clinical social worker in the home health or hospice setting, each 15 minutes) |
$14.50 |
$16.11 |
$15.29 |
$16.11 |
$16.11 |
$14.20 |
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Physician Services (non-hospice services) |
Fee for Service - Section 90 |
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* Rural Maine - All other counties |
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Adjustments for affected claims:
If you have been billing these codes at a higher rate than is indicated in the table above, we will reprocess your claims and no provider action is needed.
If you have been billing these codes at a lower rate than is indicated in the table above, please adjust the affected claims. Providers will have 120 days from the date of this notice to submit corrected adjustments, with the focus on the older dates of service first.
For questions, please contact your Provider Relations Specialist.
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