Hospice Billing Services

Hospice billing works differently from most healthcare billing. Medicare generally pays a daily rate based on the level of care, not a fee for each visit. Each claim depends on a timely election notice, a correct level of care, and the right place-of-care code on every line.

Small errors can hold up payment for a whole stay. A late notice, a mismatched level of care, or a missing discharge can all cause trouble. Westmont Revenue Partners connects hospice organizations with vetted medical billing experts who work with these rules every day. Good hospice billing keeps your clinical team focused on patients while the claims side stays clean and current.

Who this is for

• Freestanding and hospital-based hospice agencies
• Non-profit and for-profit hospice organizations
• New hospice startups preparing for their first claims
• Hospices with inpatient units or residential hospice homes
• Agencies that serve patients in private homes, assisted living, and nursing facilities

What gets billed

• Routine home care days
• Continuous home care for short periods of crisis symptom control
• General inpatient care for symptoms that cannot be managed at home
• Inpatient respite care for caregiver relief
• Physician and nurse practitioner services tied to the hospice benefit
• Skilled nursing visits reported for the final days of life
• Medical social service visits reported for the final days of life
• Drugs, supplies, and equipment related to the terminal illness
• Non-covered room and board charges in facility settings
• Notices of election, change of hospice, and revocation or discharge

Commonly billed codes

Code	Type	What it covers
0651	Revenue code	Routine home care days
0652	Revenue code	Continuous home care
0655	Revenue code	Inpatient respite care
0656	Revenue code	General inpatient care
0657	Revenue code	Physician services under the hospice benefit
0551	Revenue code	Skilled nursing visit lines
0561	Revenue code	Medical social service visit lines
G0299	HCPCS	Registered nurse visit line, used with revenue code 0551
G0300	HCPCS	Licensed practical nurse visit line, used with revenue code 0551
G0155	HCPCS	Clinical social worker visit line, used with revenue code 0561
Q5001	HCPCS	Care provided in the patient's home
Q5002	HCPCS	Care provided in an assisted living facility
Q5006	HCPCS	Care provided in an inpatient hospice facility
GV	Modifier	Attending provider not employed by or paid under arrangement with the hospice
GW	Modifier	Service not related to the terminal condition, billed by outside providers

Note

Codes are examples for orientation, not a complete list, and do not guarantee coverage or payment. Always check current code sets and payer policy.

Billing challenges in hospice

Notice of election timing. Medicare generally expects the election notice to be filed within a few days of admission. Late filing can mean unpaid days. An experienced hospice biller tracks each admission date and files the notice right away.

Level of care and place of care mismatch. Each level of care allows only certain place-of-care codes. A mismatch can cause a claim to return. Billers check the pairing on every line before release.

Related versus unrelated conditions. Care for conditions unrelated to the terminal illness may be billed by other providers. Clear documentation and the right modifiers help avoid denials on both sides.

Visits in the last days of life. Medicare reports certain nurse and social work visits close to death as separate lines. Billers confirm that visit records support each line.

Transfers, discharges, and revocations. A patient who changes hospice, is discharged, or revokes the benefit needs matching notices and claims. Billers watch benefit period dates so the records line up.

Facility room and board. Room and board in a nursing home is usually not paid by the hospice benefit itself. Billers coordinate with the facility and Medicaid where it applies.

Aggregate and cap limits. Hospices are subject to program caps. Billers who understand these limits help leaders monitor them early.

How Westmont can help

• Match your hospice with vetted billing experts who know election notices, levels of care, and place-of-care coding
• Support end-to-end revenue cycle work, from admission to payment posting
• Help with denial management and claim returns
• Connect you with experts who can help with enrollment and credentialing questions
• Offer a way to compare options before you commit

Frequently asked questions

How is hospice billed differently from other care?

Medicare generally pays hospice a daily rate that depends on the level of care. Claims are filed on the institutional claim form and carry revenue codes, a place-of-care code, and dates. It is not a visit-by-visit fee schedule. Rules can change each year, so check current Medicare updates.

What is a notice of election?

It is the filing that tells Medicare a patient has chosen hospice. It starts the benefit period for payment. Medicare generally expects it within a few days of the admission date. Late notices can lead to days that are not paid, so many hospices track this deadline closely.

What are the four levels of hospice care?

They are routine home care, continuous home care, general inpatient care, and inpatient respite care. Each has its own revenue code. Each also allows only certain places of care. Your billing team must match the level to the documented care for each day.

Can outside providers bill for a hospice patient?

Yes, in some cases. Care for conditions unrelated to the terminal illness may be billed separately, often with a modifier that signals the relationship. Care that is related is usually handled by the hospice. Your biller should review each case against current Medicare and payer guidance.

Can I outsource hospice billing?

Many agencies do. Westmont does not submit claims itself. We connect you with vetted medical billing experts who handle hospice claims, notices, and follow-up. You can ask them about scope, reporting, and how they work with your clinical software.

Related billing services

• Home Health Billing
• Palliative Care Billing
• Nursing Home Billing
• Assisted Living Billing
• Hospital Billing