WV · guidance
W. Va. BMS Provider Manual § 509.9
Reimbursement Procedures
Hospice services are billed using the UB-04 paper form or electronic form 837i. Only one level of care
under one Medicaid Revenue Code may be billed for a given day. Reimbursement is made for each day
an eligible Medicaid member is under Hospice care.
Inpatient rates for revenue codes 0655 and 0656 are paid for the date of admission and all subsequent
inpatient days with the exception of the date of discharge. The date of discharge will be paid at the RHC
rate.
If the member dies as an inpatient, then the date of death will be reimbursed at the inpatient rate if the
inpatient care was related to the terminal illness. Reimbursement will be based upon the county in which
the Hospice service is rendered.
The SIA payment amount is calculated by multiplying the CHC rate (per 15 minutes) by the number of
units for the combined visits for the day (payment not to exceed 16 units) and adjusted for geographic
differences in wages according to Medicare Chapter 11 30.2.2 Service Intensity Add-on Payments.
Provenance
- Source
- bms.wv.gov
- Retrieved
- 2026-10-01
- Edition
- bms-509-2020-05-01
- Content hash
406d61fb08df1c0229b19e461109ecb46d0efbe7ec45ba24853e0c0beef8e9be
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