Ind. IHCP Hospice Services Provider Reference Module, Section 1, Hospice Levels of Service

Hospice providers are required to comply with federal hospice regulations at 42 CFR 418 and the

Balanced Budget Act of 1997, which requires hospice providers to list on the hospice plan of care all

hospice covered services, in frequency and scope, necessary to treat the terminal illness and related

conditions. See the Hospice Plan of Care Documentation Requirements section for more information about

plan-of-care requirements.

Furthermore, hospice providers must provide care based on the medical acuity of the member at one of four

distinct hospice levels of service:

• Routine home hospice care

• Continuous home hospice care

• Inpatient respite hospice care

• General inpatient hospice care

The level of service delivered is determined by the hospice provider within the context of overall use and

reimbursement limitations described in Section 6: Billing and Reimbursement.

Inpatient hospice care must be provided in an inpatient unit or contracted inpatient facility that meets the

parameters at 42 CFR 418.110 et seq.

For purposes of reimbursement, a distinction is made between a home in a nursing facility and a home in any

other type of setting. However, each of these locations is considered the home of a hospice member because it

is the member’s normal place of residence. (See the Location of Routine or Continuous Home Hospice Care

section.)