AR2728
Expert
I'm in desperate need of documentation that supports the answer to this question:
Can the GW modifier be appended to physician visits unrelated to the hospice condition even though he is employed by or in agreement with Hospice?
WPS is our Medicare carrier and the site specifically states:
Medicare Part B can reimburse for the attending physician services ONLY when there is NO employment or arrangement between the attending physician and the hospice. Please note: Medicare considers a physician volunteering with the hospice to be an employee.
However, the modifier fact sheet for GW (services unrelated to the terminal condition) doesn't specify that this can NOT be used by the attending physician employed or in agreement with Hospice.
I feel it's very black and white in the first paragraph-there is no exception. However, without something stating the employed physician can't use GW, I'm stuck with a physician who believes he should be able to bill Medicare Part B.
Can the GW modifier be appended to physician visits unrelated to the hospice condition even though he is employed by or in agreement with Hospice?
WPS is our Medicare carrier and the site specifically states:
Medicare Part B can reimburse for the attending physician services ONLY when there is NO employment or arrangement between the attending physician and the hospice. Please note: Medicare considers a physician volunteering with the hospice to be an employee.
However, the modifier fact sheet for GW (services unrelated to the terminal condition) doesn't specify that this can NOT be used by the attending physician employed or in agreement with Hospice.
I feel it's very black and white in the first paragraph-there is no exception. However, without something stating the employed physician can't use GW, I'm stuck with a physician who believes he should be able to bill Medicare Part B.