Is it appropriate to bill HCPCS Q5002 (Assisted living facility – ALF) with a respite (revenue code 655) level of care?
An ALF is not appropriate for inpatient care – this needs to be provided in a skilled nursing facility (SNF), hospital, or hospice inpatient facility. Our quick reference tool, titled Summary of Hospice Changes summarizes CR 6778, which states that claims will be returned to provider when they are billed with respite and a Q5001 or Q5002 HCPCS code. Therefore, respite care cannot be billed with the Q5002 (ALF) HCPCS.
