decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Answer_Book / Hospice_Care / Two_paths_for_reimbursement
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Article Overview
This article covers Medicare reimbursement pathways for physician services in the hospice setting. It is aimed at physicians, coders, and billing staff who need to understand when services are billed through the carrier versus the hospice intermediary, and it notes the role of hospice benefit status and CMS guidance.
Why This Topic Matters
Hospice billing can change depending on the relationship of the physician services to the hospice benefit and the patient’s coverage status. Understanding the general framework helps billing teams route claims appropriately and avoid common submission problems.
What You Will Learn
- How Medicare distinguishes hospice-related physician services for billing purposes
- How hospice benefit status can affect reimbursement pathways
- The general role of CMS guidance in hospice billing scenarios
- When physician services are handled through the carrier versus the hospice intermediary
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Hospice administrators
Modifiers Discussed
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