1. Understanding Hospice Care
   1. Who Should be Referred for Hospice Care?
   2. Types of Hospice Care
   3. Reimbursement for Services
   4. Guide for Hospice Eligibility
2. Capital Hospice Services
3. Educational Services
4. Primary Hospice Contacts

Understanding Hospice Care

Reimbursement for Services

The Centers for Medicare & Medicaid Services (CMS), a Federal agency within the U.S. Department of Health and Human Services, administers the Medicare program.  Here, briefly, are three issues that seem to be at the center of confusion over billing:

1 - Who to Bill

• All attending physician services must be billed directly to Medicare Part B. Please do not bill these services to Capital Hospice, as we cannot provide reimbursement.
• All consulting physician services should be billed directly to Capital Hospice, but you must use the proper consulting code to qualify for reimbursement. If the wrong code is used, we cannot reimburse.
• Please note that Capital Hospice can only reimburse for services that have been authorized in the patient’s Hospice Plan of Care.

2 - Attending Physician Services Qualified for Reimbursement

• Time spent providing Hospice Plan of Care oversight (phone consultations, etc)
• Visits made to treat the patient’s hospice diagnosis in any setting—hospital, nursing home, or in the home—where the patient is receiving hospice care
• If a Capital Hospice patient asks you to treat a medical problem unrelated to the hospice diagnosis, you can still bill regular Medicare.
• While the patient is receiving services under the Medicare Hospice Benefit, coverage for any services unrelated to the hospice diagnosis remains in effect.  There is no loss of coverage.

3 - Services Not Covered by the Medicare Hospice Benefit

• Under the Medicare Hospice Benefit, Medicare will not pay for any curative services directed at the patient’s life-limiting illness. Although the Medicare Hospice Benefit excludes services unrelated to the hospice diagnosis, the patient’s regular Medicare coverage remains in effect and does cover such services. 

We realize that this can be confusing and so we are happy to answer your questions. Please contact Accounts Payable at 703-531-6233 or by email.