MedCity Influencers, Consumer / Employer

CMS Affirms Value of the Medicare Hospice Benefit’s Unique, Holistic Care

CMS is to be recognized for taking action to establishing chaplaincy codes along with other core services so that  hospice claims data on spiritual care can be collected.

Hospice is a unique benefit under the Medicare program because of its holistic approach to end-of-life care. With recent action, the U.S. Centers for Medicare and Medicaid Services has affirmed the validity of hospice’s whole-person approach to care and the value brought by each member of the interdisciplinary care team in providing it.

Compassus commends CMS for approving three new Healthcare Common Procedure Coding System (HCPCS) codes for chaplain services for Medicare beneficiaries utilizing the hospice benefit. CMS will now have the opportunity to collect data on visits for spiritual support in the same way it does for other core disciplines – physicians, nurses, social workers and aides.

The modern hospice movement began in the 1960s and its founder, Dame Cicely Saunders, established spiritual care as one of four pillars of practical hospice care alongside medical, psychological and social care. The Medicare hospice benefit was signed into law in 1983 and its conditions of participation defined by CMS require the interdisciplinary team to work together “to meet the physical, medical, social, emotional and spiritual needs of hospice patients and their families.”

Spiritual care is offered to all hospice patients regardless of faith or belief and hospice chaplains come from diverse educational and spiritual backgrounds. Numerous studies have affirmed the positive impact on quality of life and satisfaction that results when compassionate care that addresses an individual’s spiritual needs is provided.

Consistent with the whole-person approach of hospice, spiritual care is provided in a culturally relevant manner that respects each individual’s beliefs and practices. Chaplains connect with patients and families differentially than other care team members. They address concerns and fears, hopes and dreams, regrets, and most cherished memories of personal fulfillment. They also attend to the emotional and spiritual needs of families in bereavement after the death of their loved one.

Since 2008 CMS has required Medicare hospices to report claims data using HCPCS codes for the physician, nurse, aide and social worker visits. In 2010, data about visits by physical, occupational and speech-language therapists was added. Despite the importance and requirement to meet the spiritual needs of patients and families, however, no hospice chaplaincy claims codes existed or reporting was required until 2020—and then exclusively for care provided to veterans by the Veterans Health Administration.

CMS is to be recognized for taking action to establishing chaplaincy codes along with other core services so that  hospice claims data on spiritual care can be collected. In the near future, we hope to see quality measures adjusted to encompass the impact of spiritual care on hospice quality of care to give consumers seeking high-quality hospice care as much information as possible. Quality measures required by the Hospice Quality Reporting Program are publicly reported and available on Medicare’s Care Compare website.

Photo: LPETTET, Getty Images


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Laura Templeton

Laura Templeton is executive vice president and chief operating officer at Compassus, a national leader in post-acute care, providing a full suite of home-based care services including home health, infusion therapy, palliative care and hospice.

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