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December 2016

We’re changing our reimbursement policy for hospice services

For dates of service on or after March 1, 2017, Blue Cross Blue Shield of Michigan is launching a statewide rate for each billable hospice revenue code. For 2017, Blue Cross will apply the 2016 highest Core-Based Statistical Area rate as the new statewide rate schedule. The new pre-hospice and hospice reimbursement amounts were published on web-DENIS on Nov. 21, 2016.

Revenue code 0659 replaced with 0658

In addition, Blue Cross is modifying its reimbursement policy for members with the nursing home plus hospice support benefit. Today, hospices providing this benefit bill revenue code 0659, and the payment rate covers both the room and board as well as support services. For dates of service on or after March 1, 2017, providers will no longer bill revenue code 0659 but instead use revenue code 0658.

The statewide rate for 0658 will cover only room and board. Providers will bill revenue code 0651 in conjunction with 0658 for the provision of the routine home care portion. This change applies to Blue Cross members with the hospice plus nursing home support benefit.

To determine if a member has hospice plus nursing home support coverage, refer to the Provider Automated Response System, or PARS, and the web-DENIS subscriber information screens.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2015 American Medical Association. All rights reserved.
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