Coinsurance on Inpatient Respite Care

70.3 - Coinsurance on Inpatient Respite Care (Rev. 4280, Issued: 04-19-2019, Effective: 07-21-19, Implementation: 07-21-19) The hospice may charge the beneficiary a coinsurance amount equal to 5 percent of the national Medicare respite care rate, after adjusting the national rate for local wage differences. This coinsurance is not counted toward the hospital deductible, but it is limited to the same amount. EXAMPLE Assume a wage adjusted inpatient respite care rate for the year (as provided by the A/B MAC (HHH)) of $100. The maximum coinsurance rate would be $5. The hospice may charge any amount up to and including $5 for inpatient respite care only. The total amount of coinsurance for inpatient respite care for any beneficiary during a hospice coinsurance period may not exceed the amount of the inpatient hospital deductible applicable for the year in which the hospice coinsurance period began. A hospice coinsurance period begins with the first day for which an election for hospice services is in effect for the beneficiary and ends with the close of the first period of 14 consecutive days on which no such election is in effect for the beneficiary. EXAMPLE Mr. Brown elected an initial 90-day period of hospice care. Five days after the initial period of hospice care ended, Mr. Brown began another period of hospice care under a subsequent election. Immediately after that period ended, he began a third period of hospice care under an additional election period. Since these election periods were not separated by 14 consecutive days, they constitute a single hospice coinsurance period. Therefore, the maximum coinsurance for respite care during all three periods of hospice care may not exceed the amount of the inpatient hospital deductible for the year in which the first period began. No other coinsurance may be charged by the hospice.