Ind. IHCP Hospice Services Provider Reference Module, Section 6, Method of Calculation

The total hospice per diem amounts reimbursed to a hospice provider are calculated according to the

member’s level of service and the member’s location of care as listed:

• Routine home hospice care delivered in the home (any residential setting other than a nursing

facility) – IHCP hospice per diem only

• Routine home hospice care delivered in a nursing facility – IHCP hospice per diem plus room and

board per diem

• Continuous home hospice care delivered in the home (any residential setting other than a nursing

facility) – IHCP hospice per diem only

• Continuous home hospice care delivered in a nursing facility – IHCP hospice per diem plus room

and board per diem

• Inpatient respite hospice care for members regardless of their place of residence – IHCP hospice per

diem only (Note: There is no additional room and board per diem for this service.)

• General inpatient hospice care regardless of the member’s place of residence – IHCP hospice per

diem only (Note: There is no additional room and board per diem for this service.)

These reimbursement rules are listed in Tables 6 and 7.

Table 6 – Hospice Reimbursement for Members Receiving Services at Home

Level of Service Private Home, Assisted Living, ICF/IID

Hospice Per Diem Room and Board

Routine home Yes No

Continuous home Yes No

Inpatient respite Yes No

General inpatient Yes No

Table 7 – Hospice Reimbursement for Members Residing in a Nursing Facility

Level of Service Nursing Facility

Hospice Per Diem Room and Board

Routine home Yes Yes

Continuous home Yes Yes

Inpatient respite No No

General inpatient Yes No