Medicare Hospice Benefit & Physician Billing
Medicare Part A covers hospice patient expenses and regulates how physicians bill for their services. For most eligible patients, Medicare pays for hospice 100 percent, including visits by a nurse, physician and other healthcare professionals, as well as therapy, medication and supplies—although certain prescription drugs and additional services such as inpatient respite care may require small out-of-pocket payments.
In most states, Medicaid (Medi-Cal in California) also provides hospice coverage and palliative care, while additional insurance plans, such as traditional HMOs, can supplement healthcare expenses unrelated to a patient’s terminal diagnosis.
Billing for Advance Care Planning
Physicians, physician assistants and nurse practitioners can bill Medicare for the time they spend in face-to-face discussions about advance care planning and end-of-life care decisions with their patients or their patient’s beneficiaries/surrogate.
Medicare Hospice Benefit
Medicare covers 100 percent of VITAS hospice services under Medicare Part A, and the attending physician can continue to bill Medicare Part B for professional services. Learn more about the hospice benefit and download our PDF.
Physician Billing for Medicare Hospice Patients
Once a Medicare patient elects hospice, care related to the terminal diagnosis is paid directly by CMS to the hospice provider. Physician services are billed by the hospice according to the nature of the service performed. Learn more about physician billing.
Quick, Secure and Simple
Refer your hospice-eligible patient easily. The VITAS app features:
- HIPAA-compliant hospice referrals
- Interactive scale to determine eligibility
- Disease-specific guidelines
Available for Android and iOS devices.Download now