Resources for Physicians: Caring for your patient on hospice


Consistent with hospice philosophy, Angela Hospice encourages the continuation of the existing physician-patient relationship while your patient is receiving hospice services. We admire your willingness to remain involved with the care of your patient during this difficult time. Our nursing staff will look to you to provide all orders and guidance for the care of your patient.

Below you will find some basic facts to guide you as you continue to direct your patient’s plan of care.

Hospice Goal

Angela Hospice is committed to working with all people at the end of their lives. We go to every extreme to provide optimum palliative care to alleviate suffering in all its forms.  The purpose of hospice is neither to hasten death nor prolong life. We work diligently to maintain comfort and quality of life while the disease naturally progresses.

Reimbursement for Your Services

While your patient is receiving hospice services, you continue to receive the same reimbursement you previously received for your physician services. If the patient is able to come to you for an office visit or if you wish to make a home visit, you may bill the appropriate code. Even if you never see the patient you may bill insurance companies for supervising his or her care while receiving hospice services.

The Medicare billing codes for home visits and supervision are as follows:

Code (CPT)

Description

99341      

New Patient Straightforward in Home Care

99342

New Patient Low Complexity in Home Care

99343

New Patient Moderate Complexity in Home Care

99344

New Patient Moderate Complexity+ in Home Care

99345

New Patient High Complexity in Home Care

99347

Established Patient Straightforward in Home Care

99348

Established Patient Low Complexity in Home Care

99349

Established Patient Moderate Complexity in Home Care

99350

Established Patient High Complexity in Home Care

G0182

Physician supervision of hospice patient when patient is not present. It can be billed every month if there was 30 minutes or more of time spent on the case.


Hospice Revenues & Regulations

Angela Hospice receives reimbursement from the traditional insurance sources but primarily from Medicare. Medicare and most other insurance payers reimburse hospices on a capitated basis. Our policies, as in many other medical fields, are structured around Medicare’s regulations.

When you decide that your patient has a prognosis of six months or less, that patient may elect their insurance’s hospice benefit. This benefit entitles a patient to hospice care which includes physician services, nursing, social work, spiritual care, nurses’ aides, volunteers, bereavement, and all medication and equipment related to the terminal disease. It also entitles the patient to receive some ancillary services such as physical, speech, or occupational therapy if needed.

Hospice’s reimbursement is capitated and each insurance company pays a fixed daily amount for each patient. Out of that daily rate we pay for all aforementioned expenses. Medications and treatments for conditions other than the terminal disease may be billed separately and are not included in the daily capitated rate.

Medications and Labs

Due to the capitation, we are careful and practical about which services we provide.  It is a good idea to review the medications that a patient is on and see whether they are still useful while receiving hospice services. Many preventative or prophylactic medications, such as anti-lipids or antihypertensives are no longer needed on hospice.  We want to focus on medications used to provide comfort. 

 

Medical Director Services

Dr. James Boal has been Angela Hospice’s full time medical director since 2000. He is double board certified in Family Practice and in Hospice and Palliative Medicine. Dr. Boal and the rest of the Angela Hospice physician team are available to answer any questions you have about hospice care. They are also available to make home visits to your patient if you so desire or are unable to see your patient.

 


Resources





Compassionate care for children, adults, and families since 1985

Angela Hospice is a Felician-sponsored ministry

Angela Hospice Home Care
14100 Newburgh Road
Livonia, Michigan 48154-5010
TEL: 734.464.7810
Toll Free: 866.464.7810