Reader Questions: Review the Particulars on Billing Medicare for Hospice Care

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article addresses a Medicare hospice billing question from a provider perspective. It explains the general issue of who may be financially responsible for physician services when a patient is in hospice, discusses resubmitting claims when needed, and notes a hospice-related modifier that may be relevant in this situation. The piece is useful for physicians, billing staff, and coders who work with Medicare claims for hospice patients and want to understand the broad billing and enrollment context.

Why This Topic Matters

Hospice enrollment can affect how physician services are billed and which entity may be responsible for payment. Understanding the general coordination issues can help reduce denied claims and improve claim accuracy.

What You Will Learn

  • How hospice enrollment can affect Medicare billing for physician services
  • What general claim follow-up steps may be considered after a denial
  • Why hospice enrollment status should be checked before providing services
  • How hospice-related payer coordination is discussed in a billing context

Who Should Read This

  • Physicians
  • Medical coders
  • Billing specialists
  • Practice managers
  • Revenue cycle staff

Modifiers Discussed

  • HCPCS Level II: GV

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