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January 3, 2019

Hospice Self-Determined Aggregate Cap Reminder

Hospices are required to file the self-determined cap each year, between December 31 and February 28. The 09/30/18 Self-Determined (SD) Caps are due no later than February 28, 2019. Late letters will be sent and withholds applied on March 7, 2019. If you have not submitted your SD Cap please do so as soon as possible to avoid being put on withhold.

CGS processes SD Cap submissions on a First In First Out basis. If your agency is put on withhold, possibility exists you could stay on withhold for several days after we receive your submission, depending on number in front of you to be reviewed.

As a reminder, the Hospice Caps Web page was created on the CGS website to assist hospices with this process. This Web page includes a link to the "Provider Self-Determined Aggregate Cap Limitation" form, as well as instructions for completing the form.

Hospices are responsible for obtaining their own Provider Statistical and Reimbursement (PS&R) summary from the CMS websiteExternal Website. CGS will not provide this to hospices. An instruction for obtaining your PS&R reports is also available from the Hospice Caps Web page. If a hospice is unable to obtain a copy of their PS&R reports or you have any questions, please contact Tom Bisbee at CGS, at 615-660-5560 for assistance.

Refer to the Hospice Caps Web page for more detailed information about this process and links to additional resources.

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