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How to Bill Services for Hospice Patients for services related to hospice diagnosis

Primary (Attending) Physician

  • Bill Medicare Part B or applicable intermediary using your usual electronic system and the applicable CPT E&M code for the service. Include the GV modifier, which indicates that the attending is not employed by Hospice but is treating the terminal condition.
  • If you are authorized to give medication or perform a procedure, bill the medication and the technical component to Hospice of Broward County and the professional component to your Part B carrier.
  • You will be paid 80% of the Medicare allowable.  You may bill the patient, or their secondary insurance, for the remaining 20%. Medicare reimburses the physician.

Consulting (or Second) Physician

You must sign a Physician Consulting Agreement with Hospice of Broward County.

  • Physician bills Hospice of Broward County using applicable CPT codes for both professional and technical components using HCFA 1500 form. Hospice bills Medicare Part A.

  • You will be paid per contract amount with Hospice of Broward County and will not bill the patient or a secondary insurance for any component of the bill. Hospice of Broward County reimburses the consulting physician.

For a Non-Hospice Diagnosis

Attending and Consulting Physicians

  • Bill Medicare Part B or applicable intermediary using your usual electronic system and the applicable CPT E&M code for your service. Include the GW modifier, which indicates the services are not related to the terminal diagnosis.
  • If you receive a denial because the patient is on hospice, request a denial letter. Include this letter with your resubmission.
  • You will be paid 80% of the Medicare allowable. You may bill the patient or their secondary insurance for the remaining 20%. Medicare reimburses the physician.