• General Information
  • Introduction
  • Core and Other Functions of Hospice
    • Introduction
    • Core Functions
    • Other Functions
  • Provider Certification
  • Scope of Service
  • Medicaid Provider Responsibilities
  • Hospice Responsibilities
  • Recipient Eligibility
  • Hospice Enrollment
  • Hospice Recipient Requirements
    • Designated Primary Provider
    • Discontinuation or Transfer
    • Recipients Residing in Nursing Homes
  • Copayment
• Covered Services
  • Hospice Care Service Categories
  • Hospice Care Services and Limitations
    • Introduction
    • Routine Care
    • Continuous Care
    • Inpatient Respite Care
    • General Inpatient Care
  • Nursing Home Room and Board
    • Introduction
    • Limitations Applicable to Nursing Home Room and Board
  • Physician Services
  • Durable Medical Equipment/Personal Care Services
  • Reimbursement Not Available
• Required Documentation
  • Introduction
  • Physician Certification/ Recertification of Terminal Illness
  • Recipient Election of Medicaid Hospice Benefit
  • Notification of Medicaid Hospice Benefit Election
  • Plan of Care
  • Ordering Forms
  • Form Retention and Submission
• Prior Authorization
  • Introduction
  • Prior Authorization for Personal Care Services
• Claims Submission
  • Introduction
  • Coordination of Benefits
  • 837 Health Care Claim: Institutional
  • UB-92
  • Billed Amounts
  • Billing Increments
  • Diagnosis Codes
  • Revenue Codes
  • Fee Schedule
• Reimbursement
  • Introduction
  • Nursing Home Room and Board
    • Introduction
    • Paper Adjustment Requests
  • Patient Liability
  • Hospice Cap on Overall Reimbursement
• Appendix
  • Appendix 1 — UB-92 (CMS 1450) Claim Form Instructions for Hospice Services
  • Appendix 2 — UB-92 Claim Form Sample
  • Appendix 3 — Physician Certification/ Recertification of Terminal Illness
  • Appendix 4 — Notification of Medicaid Hospice Benefit Election
  • Appendix 5 — Recipient Election of Medicaid Hospice Benefit
  • Appendix 6 — Hospice Benefit Revocation (Non-recertification)/ Voluntary Discharge
  • Appendix 7 — Allowable Revenue Codes for Hospice Care
  • Appendix 8 — Rounding Guidelines for Continuous Care
  • Appendix 9 — Services Provided Outside the Hospice Benefit
  • Appendix 10 — Sample Adjustment/ Reconsideration Request for Retroactive Nursing Home Rate Adjustment
• PDF

 

 

 

DATE:	January 3, 2006
TO:	Wisconsin Medicaid-Certified Hospice Providers
FROM:	Mark B. Moody, Administrator Division of Health Care Financing
SUBJECT:	Wisconsin Medicaid Hospice Services Handbook

The Division of Health Care Financing (DHCF) is pleased to provide a copy of the new Hospice Services Handbook to providers. This handbook articulates current Medicaid policies found in Wisconsin Administrative Code, HFS 101-108, as they apply to hospice services.

The Hospice Services Handbook incorporates current Medicaid hospice policy information into a single reference source. The handbook replaces the Part S, the Hospice Handbook, originally issued on August 1, 1990, and the following service-specific Wisconsin Medicaid and BadgerCare Updates:

• The November 1996 Update (96-43), titled “Hospice Services: Patient Liability, Required Forms, and Commonly Asked Questions.”
• The June 1999 Update (99-21), titled “Hospice handbook replacement pages.”
• The November 2000 Update (2000-51), titled “Billing personal care for hospice recipients.”
• The June 2003 Update (2003-32), titled “Changes to patient liability billing due to HIPAA.”
• The June 2003 Update (2003-38), titled “Changes to local codes and paper claims for hospice services as a result of HIPAA.”
• The August 2003 Update (2003-93), titled “Effective dates for claims submission changes as a result of HIPAA for hospice services.”
• The December 2003 Update (2003-161), titled “Hospice reimbursement rate increase.”
• The July 2004 Update (2004-57), titled “Submitting Adjustment Requests for Retroactive Rate Changes.”
• The November 2004 Update (2004-85), titled “Hospice Reimbursement Rate Increase.”

This handbook does not replace the All-Provider Handbook, all-provider Updates, the Wisconsin Administrative Code, or Wisconsin Statutes. Subsequent changes to hospice service policies will be published first in Updates and later in revisions to the Hospice Services Handbook.

Additional Copies of Publications

The Wisconsin Medicaid Web site, dhs.wisconsin.gov/medicaid/, contains additional information for all Medicaid providers, service-specific information, and electronic versions of the Hospice Services Handbook and the All-Provider Handbook.

Providers who have questions about the information in this handbook may call Provider Services at (800) 947-9627 or (608) 221-9883.