Physician Reimbursement Information Regarding Hospice Medicare/Medi-Cal Benefit
When your patient elects the Hospice Benefit, you are reimbursed for your services. Here is how the reimbursement works:
Medicare/Medi-Cal will pay only you, as the designated attending physician, for palliative services related to the terminal diagnosis. You should continue to bill as usual. (Medicare billers see below**). Medicare will pay you, the Attending Physician, for Physician Oversight for Care Planning to report physician supervision of a hospice patient.
Hospice of Santa Cruz County (HSCC) is paid a separate per diem rate to provide home care, pharmaceuticals, durable medical equipment, or any other service or treatment related to the terminal diagnosis. We are also reimbursed a per diem rate for in-patient hospitalization and/or respite in a skilled nursing facility.
Since HSCC acts as the Health Maintenance Organization for hospice patients, if you determine a need to discuss your patient’s Plan of Care, to perform diagnostic tests, to bring in a consultant, or to hospitalize your patient for anything related to their terminal diagnosis, please contact us at (831) 430-3000. There is a nurse on-call 24 hours a day as well as the availability of our Medical Directors.
If in-patient hospitalization is needed for palliative care related to the terminal diagnosis, HSCC will schedule and coordinate the admission process and plan of care with you and our Medical Director.
Thank you for your continued support of Hospice of Santa Cruz County
**Attention: Medicare Biller
When billing under Medicare Part B, Hospice of Santa Cruz County provider number is 051526 and NPI is 1760454672.
For professional services related to the patient’s terminal diagnosis, bill Medicare Part B using CPT code with GV modifier.
For professional or technical services not related to the patient’s terminal diagnosis, bill Medicare Part B using CPT code with GW modifier.