Skip to Main Content
Issue Number - Name
0105-Physician Services during Hospice Period
Review Type
Automated
Claim Type
Physician/Non-Physician Practitioner
Region and State
RAC 1-4
All States
Date Approved
07/10/2018

Description

Physician services billed during an active hospice period should be paid by the hospice provider if services are related to the hospice beneficiary's terminal condition or if a physician is employed or paid under arrangement by the beneficiary's hospice provider. Medicare should not be billed for either of the aforementioned scenarios.

Affected Code(s)

None

Applicable Policy References

  • 42 CFR, Part 418.402
  • CMS Pub. 100-02, Medicare Benefit Policy Manual, Chapter 9, Section 10
  • CMS Pub. 100-02, Medicare Benefit Policy Manual, Chapter 9, Section 40.1.3
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 11, Section 10
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 11, Section 40.2
  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 11, Section 50