SpecialtiesCare settings & programs
How we see hospice billing.
Reviewed by the VisMed care settings & programs billing team
Hospice is billed as a per-diem at one of four levels of care, under an election the patient makes and a certification the physician signs, with strict timing. The notice of election must be filed within days of the election or the hospice is not paid for the days until it is. Each benefit period needs a recertification, and later periods need a face-to-face encounter before the certification. Claims must be filed sequentially by month. Miss a step and the month is unpaid or held.
Within the per-diem sit rules on the level of care, on the higher payment for the first days of routine care, on the service-intensity add-on for visits in the last days of life, and on which physician services are billed by the hospice and which by the attending. Drugs, equipment and services related to the terminal illness are the hospice’s responsibility, and the boundaries generate disputes.
VisMed keeps an election calendar per patient, reconciles level-of-care and visit documentation to the claims each day, tracks sequential filing per month, and applies the physician-service rules per encounter.
Where hospice practices lose money
The patterns we find in the aging and denial history before anything else changes.
Notice of election late
Filed after the deadline, the days between election and filing are not paid, except in narrow exceptions.Certification and face-to-face timing
Recertifications not completed before the period, or face-to-face encounters not documented within the window for later periods, make the period unbillable.Level of care unsupported
Continuous home care and general inpatient care require documentation of the need and, for continuous care, hours by discipline. Unsupported levels are downgraded and recouped.Service-intensity add-on missed
Nurse and social worker visits in the final days of life pay an add-on when reported correctly. It is often unreported.Attending physician services
Services by the attending physician not employed by the hospice are billed differently from those by hospice physicians, and errors produce denials on both sides.
What we do differently for hospice
Specialty-matched coders and a denials specialist, working inside your own system.
We keep an election calendar per patient
Election, notice filing, period dates, recertification and face-to-face deadlines tracked, with alerts to your clinical team.We reconcile level of care daily
Documented care and visit hours matched to the level billed each day.We control sequential filing
Monthly claims filed in order, with holds resolved so the sequence does not stall.We apply physician-service rules
Hospice-employed and attending physician services billed under the correct rules and modifiers.
What we bill
The procedure and code families your account team already works in.
Hospice billing, asked and answered.
What a physician-owner in this specialty asks on the first call.
How does VisMed make sure notices of election are filed on time?
With a per-patient calendar that starts at election and alerts the team daily until the notice is filed and accepted. VisMed corrects rejected notices the same day, because every day until acceptance is unpaid.
Does VisMed track face-to-face requirements?
Yes. The window before each later benefit period is on the calendar, and VisMed tells the clinical team which patients need an encounter and by when, with the attestation documented before the certification.
What supports general inpatient or continuous care?
Documentation of the symptom crisis or need that cannot be managed at the routine level and, for continuous care, hours by discipline meeting the minimum. VisMed reconciles the documentation to the level billed each day before the claim goes out.
How are attending physician services billed?
An attending physician not employed by the hospice bills their own professional services with the modifier indicating the relationship. Hospice-employed physicians’ services are billed on the hospice claim. VisMed applies the rule per encounter.
Does VisMed track the hospice aggregate cap?
VisMed tracks admissions, days and payments against the cap through the year and gives you a running projection, so a cap overpayment is anticipated and managed rather than discovered when the demand letter arrives.
Also in care settings & programs
Federally qualified health centers
PPS rates, wrap-around and sliding-fee reporting.
Durable medical equipment
Orders, proof of delivery and competitive-bid rules.
Wound care
Debridement levels, skin substitutes and frequency edits.
Home health
OASIS-linked episodes and PDGM grouping.
Nursing homes & assisted living
Consolidated billing and Part B carve-outs.
Behavioral health
Parity rules, telehealth and group-session codes.
Substance-use treatment
Bundled programs, MAT and authorization units.
All specialties
The full list, in six groups
See where your hospice practice is losing money. Free.
Six months of aging and denials, read by people who bill your specialty every day — quantified as monthly leakage with a recovery estimate. Yours to keep.
or write directly hello@vis.med