Rainbow Hospice staff value and respect the physician’s history and relationship with each patient and family. It is indispensable in providing quality end-of-life care.

Physician Reimbursement For Hospice Patients

Medicare Part B continues to pay directly for physician visits made by the primary attending physician of an enrolled hospice patient as long as the physician is not a hospice employee or paid under an agreement with the hospice. These services are not included in the hospice per diem reimbursement.

Visit Code Modifiers for Physician Visits

Physicians can bill Medicare Part B for their services using appropriate CPT and ICD-9 codes on the 1500 claim form along with one or more of the following modifiers:

1. GV is used by the attending physician not employed by or contracted with the hospice for care related to the terminal illness.
2. GW is used by the attending physician not employed by or contracted with the hospice for care not related to the terminal illness
3. Q5 is used in addition to the GV or GW modifier when professional services are provided by a group member on behalf of the designated attending physician.
4. Q6 is used in addition to the GV or GW modifier when a substitute physician (locum tenens) provides service on behalf of the designated attending physician.

Consulting physicians and ancillary, technical services, e.g. labs and surgical procedures, are negotiated in advance and billed to Rainbow Hospice in accordance with a contract between the physician and Rainbow Hospice.