Medicare Hospice Payment

Section 512(b) of the MMA amends section 1814(i) of the Act and establishes payment for this service. The statute specifies that the Medicare payment will be made to the hospice for services provided by the hospice medical director or physician employed by the hospice. The provision of these services may not be delegated to other hospice personnel (i.e., nurse practitioners, registered nurses, social workers, etc.) and may not be furnished by a physician under contract with the hospice. We intend to monitor data regarding the use of this benefit.
Since the evaluation and counseling provision is not a service within the hospice benefit, payment for these services are not included in the hospice payment cap.
Payment to the hospice agency for the provision of this evaluation and counseling service is made using HCPCS code G0337. The national payment amount for this service for FY 2005 will be $54.57. Future changes in the rate will be identified in the Physician Fee Schedules. See Pub 100-04, chapter 11, section 10.1 for claims processing instructions.