Ind. IHCP Hospice Services Provider Reference Module, Section 1, Comparison of IHCP Hospice Covered Services and Medicare Hospice Covered Services

Table 1 demonstrates how the IHCP hospice per diem mirrors the services covered under the Medicare

hospice program, as described in the Medicare hospice conditions of participation. Hospice providers may

refer to 42 CFR 418 for a more thorough review of the Medicare hospice conditions of participation.

Note: Hospice providers are reminded that any case-specific issues about the development

of a plan of care for a Medicare beneficiary must be directed to the agency’s Part A

Medicare Administrative Contractors (MACs).

Table 1 – IHCP and Medicare Hospice Services by State and Federal Regulation

Hospice Service State Regulations Federal Regulations

Nursing services 405 IAC 5-34-8(1) 42 CFR 418.64(b) and 418.66

Medical social services 405 IAC 5-34-8(2) 42 CFR 418.64(c)

Physician services 405 IAC 5-34-8(3) 42 CFR 418.64(a)

Counseling services 405 IAC 5-34-8(4) 42 CFR 418.64(d)

Short-term inpatient care 405 IAC 5-34-8(5) 42 CFR 418.108(a)

Medical appliances and supplies 405 IAC 5-34-8(6) 42 CFR 418.106

Home health services provided by a

hospice aide or home health aide

405 IAC 5-34-8(7) 42 CFR 418.76 and 484.36

Homemaker services 405 IAC 5-34-8(8) 42 CFR 418.76

Physical therapy, occupational therapy

and speech-language pathology provided

for purposes of symptom control

405 IAC 5-34-8(9) 42 CFR 418.72

Inpatient hospice respite care 405 IAC 5-34-8(10) 42 CFR 418.108(b)

Physical therapy, occupational therapy

and speech-language pathology provided

for purposes of symptom control

405 IAC 5-34-8(9) 42 CFR 418.72

Inpatient hospice respite care 405 IAC 5-34-8(10) 42 CFR 418.108(b)

Room and board for hospice members

residing in a nursing facility

405 IAC 5-34-8(11) The Medicare program does not

provide payment for room and board.

Any other item or service specified in the

hospice plan of care, if the item or service

is a Medicare-covered service

405 IAC 5-34-8(12)