Members eligible for prehospice counseling visits

Please remember that Blue Cross Blue Shield of Michigan members who are not on Medicare are eligible for up to 28 prehospice counseling visits prior to making a decision on whether to enter hospice care.

Hospice staff will help members and families understand the care options and assist the member in getting early pain management and other services as needed. The member may continue to receive ongoing treatment while receiving hospice counseling visits.

Visits are not charged against the patient’s hospice day or dollar benefit maximums. The hospice bills these services under revenue code 0650. Only one service a day is billable.

Should the member elect hospice care, five levels of care are available: routine home care, continuous home care, inpatient respite care, general inpatient care and nursing home care with hospice support. (Not all groups cover the last level, and not all hospices provide it.) 

The following services are covered when billed by the hospice under the appropriate level of care:

• Nursing care services provided by or under the supervision of a registered nurse
• Medical-social services provided by a Michigan licensed social worker with a master’s degree or licensed social worker with a bachelor’s degree when supervised by a social worker with a master’s degree
• Counseling services for the member and caregivers when care is in the member’s home
• Direct care physician services provided by a physician employed or contracted by the hospice
• Durable medical equipment approved by BCBSM and provided by the hospice for use in the member’s home to relieve or reduce symptoms of the member’s terminal illness
• Medical appliances and supplies, including drugs and biological items, provided to relieve or reduce the symptoms of the member’s terminal illness
• Home health aide and homemaker services provided by qualified aides under the general supervision of a registered nurse. These would include services such as:
• Assisting the member in getting in and out of bed
• Bathing the member
• Caring for the member’s hair and teeth
• Laundering
• Preparing meals and feeding the member
• Physical, occupational and speech therapy to control symptoms or to enable the member to maintain daily living activities and basic functional skill
• Bereavement counseling for the family after the member’s death

For more information, refer to the online Hospice Provider manual for covered services and requirements.