When your patient elects the Hospice Benefit, you are reimbursed for your services. Here is how the reimbursement works:
- Medicare will pay only you, as the designated attending physician, for palliative services related to the terminal diagnosis. You should continue to bill as usual. (Medicare billers see below**)
- Medicare will pay you, the Attending Physician, for Physician Oversight for Care Planning to report physician supervision of a hospice patient.
- Angels Grace Hospice is paid a separate per diem rate to provide home care, pharmaceuticals, durable medical equipment, or any other service or treatment related to the terminal diagnosis. The hospice is also reimbursed a per diem rate for in-patient hospitalization and/or respite in a skilled nursing facility.
- Since Angles Grace Hospice acts like a Health Maintenance Organization for hospice patients, if you determine a need to discuss your patient’s Plan of Care, to perform diagnostic tests, to bring in a consultant, or to hospitalize your patient for anything related to their terminal diagnosis, please call Angels Grace Hospice at 1-888-444-8341. There is a nurse on-call 24 hours a day as well as the availability of our Medical Directors.
- If in-patient hospitalization is needed for palliative care related to the terminal diagnosis, Hospice needs to schedule and coordinate the admission process and plan of care with you and our Medical Director.
** For professional services related to the terminal diagnosis, bill Medicare Part B using CPT Code with GV modifier.
For professional or technical services not related to the patient’s terminal diagnosis, bill Medicare Part B using CPT Code with GV modifier.
Use HCPCS Code G0182 for billing care plan oversight (CPO).
Also see www.cms.gov/apps/physician-fee-schedule
For questions about physician billing, please call Angels Grace Hospice at 1-888-444-8341.