Reimbursement of Services


Medicare

Hospice care is a covered benefit for all people with Medicare. Coverage includes the services of the hospice team, medical supplies and prescriptions for pain management and comfort care relating to the patient's terminal illness. Standard Medicare benefits also continue for medical treatments unrelated to the terminal illness.

​Physician Billing for Hospice Care

Here are some general parameters for Medicare hospice billing:

  • Physicians utilize modifier GV for services related to the hospice diagnosis.
  • Physicians utilize modifier GW for services unrelated to the hospice diagnosis.
  • Physician Billing for Care Plan Oversight (CPO)
  • Physicians are entitled to bill Medicare for CPO requiring more than 30 minutes per month.
  • Physicians bill the Part B carrier using CPT code G0182
  • In order to be eligible, physicians must have a face-to-face encounter with the patient in the six months prior to the CPO being billed.
  • There is a limit of one bill per patient, per month.
  • In most circumstances, CPO billing does not apply for physicians working in Long Term Care facilities.

This code allows for physician communications to the healthcare professionals involved in the patient care, which includes paperwork or phone calls.

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Speak with the referral team by contacting us seven days a week, 24 hours a day. An in-person visit can be scheduled the same day it is needed.