Hospice - JA DME

Any covered Medicare services not related to the treatment of the terminal hospice condition and which are furnished during a hospice election period, may be billed to Medicare for payment. Services should be coded with the GW modifier ("service not related to the hospice patient's terminal condition"). DME MACs process services coded with the GW modifier in the normal manner for coverage and payment determinations.

It is sometimes hard to determine if items are unrelated to a hospice diagnosis. It is also rare for something not to be bundled under the episode for DME. Beneficiaries can request a "Patient Notification of Hospice Non-Covered Items, Services, and Drugs" form to be completed by Hospice that will list which items are related and which items are unrelated to the hospice episode. This form can assist suppliers with the information they require to determine if the item they are providing is eligible for coverage under DME.

Resource

CMS Hospice Center