Wash. HCA Hospice Services Billing Guide, What is not included in the hospice daily rate?

The following services are not included in the hospice daily rate:

• Dental care

• Eyeglasses

• Hearing aids

• Podiatry

• Chiropractic services

• Ambulance transportation, if not related to client’s terminal illness

• Brokered transportation, if not related to the client’s terminal illness

• Home and Community Based Long-Term Services and Supports (HCB LTSS) or

Title XIX Personal Care Services

For clients who have been assessed and approved for HCB LTSS by the local

Home and Community Living Administration (HCLA) field office, payment for

those services is made to authorized providers using HCLA program funding.

For clients who have been assessed and approved for HCB LTSS by the local

Developmental Disabilities Community Services (DDCS) field office, payment

for those services is made to authorized providers, using DDCS program

funding.

• Any services not related to the terminal condition

If the above service(s) are covered under the client’s Medicaid program, the

provider of service must follow specific program criteria and bill HCA separately

using the applicable fee schedule and billing guide.

Early periodic screening, diagnosis, and treatment (EPSDT) includes all services

that are medically necessary to address health conditions for clients age 20 and

younger. Providers may reference program-specific billing guides for services and

equipment not covered by this billing guide and must follow the rules for the

EPSDT program described in chapter 182-534 WAC. Published limits for services

covered under EPSDT, if any, may be exceeded based on agency review of

medical necessity described in WAC 182-501-0165.