A hospice is a public agency or private organization or a subdivision of either that is primarily engaged in providing care to terminally ill individuals. A hospice can be in a home in the community, or a nursing facility. Hospice provides services to meet the physical, psychosocial, social, and spiritual needs of a terminally ill individual and the individual’s family or other caregivers.
Hospice Eligibility
A member must be diagnosed with a terminal illness by a hospice or attending physician. The physician certifies, in writing, that the terminal illness will result in a projected life expectancy of six months or less if the disease follows its normal course. A hospice can be at a member’s home, if they have full Medicaid eligibility, or it can be in a facility, if the member is active on Medicaid and residing in a Medicaid licensed and certified facility.
Hospice Interdisciplinary Team
Each hospice member will be part of a hospice Interdisciplinary Team (IDT). Hospice provider staff assigned to the hospice IDT are the physician, registered nurse, social worker; and pastoral or other counselor. The IDT professional staff must provide the care and services offered by the hospice; and the IDT must supervise the care and the services provided to the member. The IDT develops a hospice Plan of Care (POC) that meets the member’s needs. The POC is updated as frequently as the member’s condition requires; but no less than every 15 calendar days.
Hospice Services
Hospice services may be provided in a home in the community or in a nursing facility. Any of the following services may be provided based on the needs of the hospice member and caregivers.
- Nursing
- Physician services
- Spiritual counseling
- Dietary counseling
- Bereavement counseling
- Hospice Aide
- Homemaker
- Volunteer Services
- Occupational Therapy
- Speech Therapy
- Physical Therapy
- Drugs & Biologicals (related to the terminal illness)
- Medical Equipment
- Short Term Inpatient Care
- Inpatient Respite
Hospice Reimbursement
A hospice provider is reimbursed a daily rate for each day that a member is eligible for hospice. There are four categories of daily rates dependent upon the type of care that the member needs on each day:
- Routine
- Continuous
- Inpatient Respite
- General Inpatient Care
Hospice Rate Sheets (Effective October 1, 2023 - September 30, 2024)
Daily rates are fixed rates that are updated annually in accordance with the posted schedule. The schedule includes both a tab for Iowa Hospice Wage Indexes and Rates, and also a tab that shows Out-of-State Hospice Wage Indexes and Rates, and can be viewed here.
For more information on the most current rates, please view the Informational Letter posted to providers here.
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