Reimbursement

The care that Hospice Hawaii provides in the residence of the patient is 100% covered by Medicare, Medicaid and most private and government insurances.  Usually there is no co-pay.  This includes:

  • Full services from the Hospice Hawaii professionals and volunteers
  • Rental of medical equipment such as hospital bed, oxygen equipment, or other necessary items
  • Medical supplies such as dressings for wounds, treatments, or catheters
  • Required prescription medication authorized by Hospice Hawaii for the palliation of symptoms related to the terminal “hospice” diagnosis

Patients residing in a nursing home or hospice residence may be charged a daily “room and board” rate. Patients may be eligible to apply for charity care, depending upon the location. The patient and family will be informed of charges prior to the start of care.  Other individual charges may apply; the patient and family will be informed in advance.

 

Billing For Your Services

As the attending physician, you can continue to bill Medicare Part B for professional services – physician office, home, inpatient or nursing home visits – in the typical manner, adding a modifier:

The following modifiers should be placed on the CMS/HCTA 1500 forms, box 24d:

  • GV” modifier: Physician has been designated by the patient as the attending. The attending is not an employee of hospice, and services are related to the hospice patient’s terminal illness.
  • GW” modifier: Physician has been designated by the patient as the attending. The attending is not an employee of hospice, and services are NOT related to the hospice patient’s terminal illness.

At the time of admission, Hospice Hawaii will send a Notice of Election to the Medicare Part A intermediary, identifying the hospice, the attending physician and the terminal diagnosis for the patient.

Advance Care Planning

Current procedural terminology (CPT) billing codes for advance care planning have been created, covering conversations about advance directives, hospice care, and other end-of-life counseling

  • CPT 99497 covers the initial 30-minute discussion (~$86)
  • CPT 99498 covers each additional 30 minutes of discussion (~$75)

Hospice Hawaii is here to support our physician partners, by enhancing and extending your care, which results in fewer phone calls, reduced hospitalizations and ER visits, and most importantly, optimal quality of life for your patient and their loved ones.