What CPT codes should a physician use when seeing a hospice patient in the nursing facility setting?
According to the Health Care Financing Administration and American Medical Association’s CPT Information Services, “there are no specific CPT codes for evaluation and management services provided by a physician to a patient receiving hospice care in any location. When a Medicare beneficiary elects the hospice benefit, Medicare pays the hospice for all services related to the terminal illness through four set per diem rates. The exception to this is physician services. General supervisory services and participation in the establishment, review, and update of plans of care provided by the hospice medical director or a physician member of the hospice interdisciplinary team are included in this hospice per diem. This would include evaluation and management services provided by a physician employed by, or providing services under arrangement with, the hospice.” “Medicare hospice regulations, at 42 CFR 418.304(c), state that services of the patient’s attending physician, who is not employed
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