WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #1156
Physician Services
Reimbursable physician services are those face-to-face care services provided by the member's attending physician that are
related to his or her terminal illness. These services are not included in the hospice cap amount, but are billed separately by the
attending physician. Wisconsin Medicaid will reimburse the lesser of the provider's usual and customary charge for the services
provided or the maximum allowable fee established for each allowable procedure.
The rates for the various types of hospice care and room and board include reimbursement for the general supervisory functions of
attending physicians who are employed by, or under contract with, the hospice. Services such as participation in the establishment
of POC (plan of care), supervision of care and services, review or updating of POC, or establishment of governing policies are
not separately reimbursed since these costs are included in the hospice rates.
Services provided by a referred physician are reimbursable only when deemed medically necessary by the attending physician and
the member is referred by the attending physician.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
97919c25b2b6a29c58cde1f48ffffcfc0472ea29e572bbc001a80bb2b1b28a42
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.