- Hospice Transfers
- Hospice Levels of Care: Routine Home Care
- Hospice Documentation Checklist
- Hospice Documentation Tips
- Implementation of the Election Statement Addendum
- Hospice Beneficiary Election Statement Addendum Frequently Asked Questions
- Documentation for Hospice Transfers
- Tips for Responding to a Hospice ADR
- General Inpatient Check Off List
- Documentation Requirements for the Medicare Hospice Election Statement
Hospice Levels of Care: Routine Home Care
There are four levels of care in the Medicare hospice benefit. Hospices are paid a per diem rate based on the number of days and level of care provided during the election period. The four levels of care are routine home care, continuous home care, inpatient respite care, and general inpatient care. This job aid will focus on the routine home care, or RHC, level of care. See the Related Content section for links to information on all of the levels of care.
Routine Home Care
The RHC level of care is billed for each day the patient is under the care of the hospice and not receiving one of the other levels of care. The payment for each day of RHC is made without regard to the volume or intensity of routine home care services provided on any given day.
Billing
The RHC level of care is reported with revenue code 0651. The units reflect the number of days of routine home care furnished to the patient during the billing cycle. When billing the RHC level of care, an HCPCS site of service location code is required to reflect the location where the services were provided. Additional information on the HCPCS site of service location codes can be found in our Hospice Site of Service HCPCS Codes Job Aid on our website.
Each time the level of care changes, report separate line items for the level of care. For example, if a patient begins the month receiving routine home care followed by a period of general inpatient care and then later returns to routine home care all in the same month, in addition to the one line reporting the general inpatient care days, there should be two separate line items for routine home care. Each routine home care line reports a line item date of service to indicate the first date that level of care began for that consecutive period.
Related Content
Information on coverage as it specifically relates to hospice (including the four levels of care) can be found in the CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 9.
Information on billing as it specifically relates to hospice (including the four levels of care) can be found in the CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 11.
Additional information on visit reporting as it relates to the routine home care level of care can be found in the CR 6440-Additional Data Collection on Hospice Claims Job Aid on our website.
Additional information on the continuous home care level of care can be found in the Hospice Levels of Care: Continuous Home Care Job Aid on our website.
Additional information on the inpatient respite level of care can be found in the Hospice Respite Periods Job Aid on our website.