Medi-Cal Provider Manual, Part 2, Hospice Care, Classification of Care

Each day of hospice care is classified into one of four levels of care:

• Routine home care

• Continuous home care

• Inpatient respite care

• General inpatient care (no respite)/hospice general care

Level of Care Core Services

Core services within each level of care include:

• Nursing services

• Physical and occupational therapy

• Speech-language pathology

• Medical social services, home health aide and homemaker/ attendant services

• Medical supplies and appliances

• Drugs and biologicals

• Physician services

• Short-term inpatient care

• Counseling

Routine Home Care

‹‹Routine home care is provided within Medi-Cal members’ homes; however, it is not

continuous home care. Routine home care (revenue codes 0650 [high rate for 0 – 60 days],

0659 [low rate for 61+ days] and 0552 [service intensity add-on (SIA) payment for last seven

days of life]) is reimbursable to hospice providers for each day that Medi-Cal members are

under the care of the hospice provider and not receiving another level of care, whether or

not they are visited in the home by the hospice provider on the days being billed. Revenue

codes 0650 and 0659 are reimbursable for days when no home visit is made, only if the

service(s) provided are consistent with Medi-Cal members’ plan of care.››

Continuous Home Care

Continuous home care consists of continuous, predominately skilled nursing care provided

on an hourly basis, for a minimum of eight hours during brief crisis periods. Home health

aide and/or homemaker services may also be provided.

Respite Care

Respite care occurs when Medi-Cal members receive care in an approved inpatient facility

on a short-term basis to provide relief for family members or others caring for Medi-Cal

members. Each episode is limited to no more than five days.

General Inpatient Care

General inpatient care occurs when Medi-Cal members receive general care in an inpatient

facility for pain control, or acute/chronic symptom management that cannot be managed in

other settings.