Physicians may hesitate to refer patients for hospice care because of a misunderstanding about loss of reimbursement.
Confusion centers around three issues: 1) how to bill for services, 2) who to bill, and 3) which services qualify for reimbursement.
We realize that this can be confusing, and so we are happy to answer your questions. Please contact Accounts Receivable at 352.854-5237 or by email (firstname.lastname@example.org).
The Centers for Medicare & Medicaid Services (CMS), a Federal agency within the U.S. Department of Health and Human Services, administers the Medicare program. The Hospice Manual, a detailed guide to billing for hospice services, on the CMS Web site.
Care Plan Oversight:
Every Hospice patient has a Plan of Care, a comprehensive but individualized plan followed by the hospice team members, as well as the family members and caregivers. Each member of the hospice team has access to this plan, which is continually updated.
The attending physician must sign off on any change that the hospice team makes to the Plan of Care. You can bill for the following with a GV modifier: :
Care Unrelated to the Hospice Diagnosis:
If a Hospice patient asks you to treat a medical problem unrelated to the hospice diagnosis, you can still bill Medicare Part B with a GW modifier.
While the patient is receiving services under the Hospice Medicare Benefit, coverage for any services unrelated to the hospice diagnosis remains in effect: There is no loss of coverage.
Under the Medicare Hospice Benefit, Medicare will not pay for any curative services directed at the patient’s life-limiting illness.