Reimbursement of Services

Reimbursement of Services

Hospice care is a covered benefit for all people with Medicare. View the list of general parameters for Medicare hospice billing to determine if you, your patient or your family member are eligible.

Medicare

Hospice care is a covered benefit for all people with Medicare. Coverage includes the services of the hospice team, medical supplies and prescriptions for pain management and comfort care relating to the patient's terminal illness. Standard Medicare benefits also continue for medical treatments unrelated to the terminal illness.

Physician Billing for Hospice Care

Here are a few general parameters for Medicare hospice billing:

• Physicians utilize modifier GV for services related to the hospice diagnosis.

• Physicians utilize modifier GW for services unrelated to the hospice diagnosis.

• Physician Billing for Care Plan Oversight (CPO)

• Physicians are entitled to bill Medicare for CPO requiring more than 30 minutes per month.

• Physicians bill the Part B carrier using CPT code G0182.

• To be eligible, physicians must have a face-to-face encounter with the patient within six months before CPO is billed.

  • There is a limit of one bill per patient per month.

  • In most circumstances, CPO billing does not apply to physicians working in Long-Term Care facilities.

This code allows for physician communications with the healthcare professionals involved in the patient care, which includes paperwork or phone calls.

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