Wash. HCA Hospice Services Billing Guide, Billing for routine home care – revenue code 0651

Payments for RHC are based on a two-tiered payment methodology:

• Days one through 60 are paid at the base RHC rate.

• Days 61 and after are paid at a lower RHC rate.

When billing for RHC level of care, enter the appropriate procedure code and

modifier. For the claim to process correctly, the revenue code, procedure code,

and modifier must be submitted on each line billed.

Procedure Code

and Modifier Description of Code or Modifier

Q5001 Hospice care provided in client’s home/residence

Q5002 Hospice care provided in assisted living facility

Q5003 Hospice care provided in non-skilled nursing facility

Q5010 Hospice home care provided in a hospice facility

TG Complex/high tech level of care (for RHC days 1-60)

TF Intermediate level of care (for RHC days 61+)

• If an RHC client discharges and readmits to hospice within 60 calendar days of

that discharge, the prior hospice days will continue to follow the client and

count toward the client’s eligible days in determining whether the receiving

hospice agency may bill at the base or lower RHC rate.

• If an RHC client discharges from a hospice agency for more than 60 calendar

days, a readmit to the hospice agency will reset the client’s hospice days.