Clarification for hospice providers billing for nursing home care with hospice support

When a patient meets the criteria for nursing home care with hospice support and has coverage for the fifth level of care, which includes room and board, billing varies depending on the patient’s coverage:

• If the patient doesn’t have Medicare coverage, bill Blue Cross Blue Shield of Michigan for routine home care (revenue code 0651) and room and board (0658).
• If the patient has Medicare with Blue Cross supplemental coverage, bill Blue Cross for room and board (0658) but bill Medicare for routine home care. You no longer need to include the Medicare payment amount for routine home care on the room and board claim you submit to Blue Cross.

If the patient’s Blue Cross hospice benefit doesn’t include coverage for the fifth level of care, then room and board isn’t a covered service and the patient is financially responsible for the cost.