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Hospice/Home Health

News
Modified: 6/17/2024
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7 and after with dates of service June 3 or later.
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list item View CMS Newsroom Center external link (Spotlights, news, media releases, outreach, mailing lists, etc.)
LCD / NCD policy information
First Coast, as the jurisdiction N Part A and B MAC, does not process claims for hospice or home health services. However, we are responsible for reimbursement to A/B providers for certification and recertification of these services.
list item Search for related LCDs using these available tools:
View First Coast’s active / proposed LCDs / articles on CMS’ Medicare coverage database (MCD) external link
Florida hospice and home health claims are processed by Palmetto GBA external link as the regional home health intermediary (RHHI). National Government Services (NGS) external link is the RHHI responsible for Puerto Rico and the U.S. Virgin Islands.
list item Search for specific LCDs or procedure codes using the appropriate contractor's LCD lookup
Medical documentation
Medical record documentation is used to verify that services were billed correctly and to ensure that payment and processing of Medicare claim(s) are accurate and based on sound policy. Find information, tips, and resources regarding medical documentation.
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Audit and compliance
list item CERT resources
list item OIG report A-09-18-03031 external link -- CMS could have saved $192 million by targeting home health claims for review with visits slightly above the threshold that triggers a higher Medicare payment
Frequently asked questions (FAQs)
Before you call the First Coast provider contact center, find answers to hospice/home health-related FAQs:
Education
Utilize educational information from First Coast and CMS on hospice/home health services.
list item Visit On-Demand Learning – access First Coast’s webcast recordings, web-based training, videos and tutorials
Additional educational opportunities
list item View Palmetto GBA upcoming events external link -- Florida hospice/home health contractor
list item View NGS upcoming events external link -- Puerto Rico and U.S. Virgin Islands hospice/home health contractor
CMS educational opportunities
list item Search for CMS upcoming events external link
list item CMS open door forums -- overview external link
CMS Internet-only manual (IOM)
The CMS’ IOMs contain day-to-day operating instructions, policies, and procedures based on statutes, regulations, guidelines, models, and directives. The following CMS IOM contains information specific to hospice and home health providers:
Resources
list item Visit the Hospice Center external link on the CMS website.
View additional resources identified specifically for hospice and home health services.
CMS and contractor resources
Professional associations
General resources
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Stay informed
Subscribe -- Stay updated on the latest Medicare information with free email subscriptions from First Coast and CMS.
View archives – Access previously published emails you may have missed.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
Part B