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Hospice News:

Know The Billing Rules For Revocations

Published on Wed May 16, 2012

MAC offers clarification on tricky billing situation.

Billing can get tricky for patients who choose to revoke their hospice election. HHH MAC NHIC offers some clarification in a newly posted question-and-answer set from its March 29 Medicare Advantage Organization (MAO)/Hospice Claim Rejections Virtual Room session

"The beneficiary chooses the effective date of the revocation," NHIC explains. "However, the time is based on when the hospice actually discharges the beneficiary from their care (due to the request for revocation)."

How to bill: "The hospice is responsible for care that occurred while the beneficiary was still on service during the last day of the hospice benefit," NHIC clarifies. The day of revocation is a billable day for the hospice, HHH MAC CGS adds in a hospice revocation tool on its website.

But another provider can also bill on that day. "The provider would start billing FFS Medicare on the date of the revocation," NHIC confirms. "The charges included on the bill would only be those charges that were incurred after the actual time of discharge/revocation. The provider would bill the hospice for any charges incurred prior to the time of the discharge/revocation."

Resource: See CGS's tool at www.cgsmedicare.com/hhh/coverage/Coverage_Guidelines/Discharge_Revocations_Transfers.html.

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