August 31, 2020: SNF and Hospice Day of Discharge Reminder

August 31, 2020: Attention SNF and Hospice Providers: Based on current MSA policy hospice providers are only reimbursed for the date of discharge in the following scenarios:

  • If the discharge matches the beneficiary’s date of death.
  • The beneficiary has revoked their Hospice benefit in favor of Skilled Nursing service at the Nursing Facility they currently reside in.
  • The Beneficiary transfers from one hospice provider to another and both providers render service on the same day

Nursing Facilities are reimbursed for the discharge date if the discharge matches the beneficiary’s date of death.

When billing for a month that includes a facility discharge, providers are allowed to bill through the date of discharge on the claim (from/to dates) but should not include the actual discharge date in the number of billed units on the claim.  Discharge payment guidelines for the respective provider types are in the Medicaid provider manual, Hospice chapter, Section 7.3.C. Date of Discharge and Billing and Reimbursement for Institutional chapter, Section 8.2.E Billed Facility Days.

Claim example:

If a Medicaid Beneficiary’s admission date 6/01/2020 with a discharge date 7/31/2020, the discharging facility would bill their room and board service line for July 2020 as:

From date of service: 7/01/2020  

To date of service: 7/31/2020 

Units = 30

When billing for the same dates but the beneficiary expired in the facility, the month of July 2020 would be billed as:

From date of service: 7/01/2020   

To date of service:  7/31/2020

Units = 31 (with the Patient Status Code 20)