MHCP Provider Manual, Hospice Services, Hospice Physician Services

Do not bill separately for physician services the physician or medical director of the hospice performs that are included in the hospice rate.

These core services include the following:

• Administrative requirements

• General supervisory tasks

• Participation in the establishment of the plans of care

• Supervision and care services, periodic review and updating plans of care

• Establishment of governing policies by the physician member of the hospice’s interdisciplinary group

If the member did not identify an attending physician on the hospice transaction form or does not have an attending physician who provided primary care before the time of the terminal illness, he or she may choose to be served by either a physician or nurse practitioner who is employed by the hospice. You must give the member a choice of a physician or a nurse practitioner.

The hospice may bill for physician services that are nonadministrative when reasonable and necessary during a face-to-face visit with the hospice recipient and not related to the certification of the terminal illness.

Follow Medicare claims processing guidelines for billing physician’s services for dual eligible hospice recipient.