What Does Room And Board Shall Not Be A Benefit Of Acf Services. Mean
Hospice Room and Board
Under the Medicare hospice benefit, room and board charges are statutorily excluded and never covered by Medicare, except when provided nether an inpatient level of care (inpatient respite or full general inpatient intendance). Room and board charges should only be submitted to Medicare when a deprival is necessary to bill some other insurance (e.g., Medicaid).
Constructive for claims submitted on/after July 1, 2012, Modify Request 7677
states that hospice providers wishing to receive a line particular denial for room and board charges may submit the charges as not-covered using acquirement code 0659 with HCPCS A9270 and modifier 'GY' on an otherwise covered hospice merits.
Submitting Room and Board Charges on a Covered Hospice Claim
In improver to the usual hospice claim information (levels of intendance discipline visits, etc.) , include the following data to betoken noncovered room and board charges:
| REV | Enter revenue lawmaking '0659' for room and board. Report other applicable acquirement codes equally usual. |
| HCPC | Enter the HCPC code 'A9270' on the 0659 revenue lawmaking line for room and lath. |
| MODIFS | Enter the modifier 'GY' on the 0659 revenue code line for room and board. |
| TOT Unit | Enter the units to reflect the number of room and lath days existence billed. |
| COV Unit of measurement | Leave this field bare. |
| TOT Accuse | Enter the full charge for the room and board on the 0659 revenue lawmaking line. |
| NCOV CHARGE | Enter the total noncovered accuse for the room and lath on the 0659 revenue code line. |
| SERV DATE | Enter the service date to reflect the starting time day of noncovered room and board. |
| REMARKS | Enter a cursory remark indicating the noncovered charges are for room and lath. |
IMPORTANT REMINDERS:
- Do not include a condition code 20 or 21 on your claim.
- Ensure the 0659 revenue code line includes the HCPC 'A9270' and modifier 'GY'.
- Ensure your claim includes REMARKS (FISS Page 04) to indicate the noncovered charges are for room and board. Claims without remarks may be returned to you.
- If your original claim did not include room and lath charges, an aligning claim (blazon of pecker 8X7) can be submitted to add the noncovered room and lath charges.
CMS Educational Resources
Updated: 10.30.12
What Does Room And Board Shall Not Be A Benefit Of Acf Services. Mean,
Source: https://www.cgsmedicare.com/hhh/education/materials/Hospice_Room_and_Board.html
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