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Billing physician services for hospice patients | Cheat sheet

Medical practices find the hospice modifiers confusing, and confusion leads to denials and payment delays.

Use the decision trees below to help you determine if the service is separately billable once a patient has elected hospice and if so, how to bill it.

There are two decision trees:

one for the attending physician and
one for other physicians, PAs and NPs.

Walk through the decision tree to see which modifier to use, modifier GW or modifier GV. For a detailed explanation, read the article Billing physician services for hospice patients

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In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.