Overview of hospice care
Medicare beneficiaries who have a terminal illness with a life expectancy of six months or less can elect to have their end-of-life care provided by a hospice organization. Medicare then pays the hospice to provide all of the care that the patient needs that is related to their terminal illness.
According to Medicare, when the patient chooses to enter hospice they waive their rights to Medicare part B payments for other services that are related to the treatment or management of their terminal illness, with the exception of care provided by their own attending physician. That is, benefits that would be paid by Part B for physician services become the financial responsibility of the hospice organization.
A patient may be discharged from hospice if they move from one area to another and transfer to a new hospice, the hospice determines that the beneficiary is no longer terminally ill, or the hospice determines the beneficiary meets their policy regarding discharge for cause.
The hospice bills Medicare with revenue codes that describe the type of care that is being provided, such as routine health care, continuous home care, inpatient respite care, or general inpatient care. There are some other services that hospice organization may bill as well.
We’ve provided a cheat sheet for billing hospice services to use as a handy quick reference.