UHC NC Community Plan hospice claims reimbursement for pts in SNF

To avoid any disruption in revenue of your facility please follow the proper coding and billing steps.


Billing for hospice room and board services:

  • Hospice provider has to bill to UHC NC Community plan
  • Frequency- monthly
  • Service facility- NPI of the SNF where the services are performed
  • Attending provider- NPI of the hospice provider

Coding for hospice room and board services:

  • Revenue codes: Intermediate level of care – 0658
    Skilled level of care – 0659

Billing for hospice services:

  • Hospice provider bills directly to UHC of NC Community Plan
  • Attending provider- NPI of the hospice provider

Coding for hospice services:

Image via UHC website

Reimbursement:

  • For room and board- UHC of NC Community Plan directly reimburses to the hospice provider- reimbursement is 95% of SNF per diem rate minus any patient liability (if aplicable)
  • Reimbursement for hospice services-UHC of NC Community Plan directly reimburses to hospice provider
  • Reimbursement to the SNF- after receiving the reimbursement from the UHC of NC and pays a per diem rate that is specified in the contract between the two entities.

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