Hospice Care
Program Coverage:
Hospice care is a form of medical multidisciplinary care that addresses the unique
requirements of terminally ill individuals.
Hospice is used to alleviate pain and suffering, and treat symptoms rather than to cure the
illness. Medical and nursing services are designed to maximize the patient’s comfort,
alertness and independence so the patient can reside in the home as long as possible.
Providers must enroll as a Medi-Cal hospice provider. All claims are submitted using the
UB-04 claim form.
Hospice providers may include the following:
- Hospitals
- Skilled nursing facilities
- Intermediate care facilities
- Home health agencies
- Any licensed health provider who has been certified by Medicare to provide hospice
care and is enrolled as a Medi-Cal hospice care provider.
Note: All services must be rendered in accordance with Medicare requirements. Hospice is
a covered optional benefit under Medi-Cal with two 90-day periods, beginning on the
date of hospice election, followed by unlimited 60-day periods. All licensed and certified hospice providers must submit the Hospice NOE form within five (5) calendar days of a Medi-Cal fee-for-service member’s hospice election date. Providers who submit hospice NOE forms after this window will be considered non-compliant and will only be reimbursed for services provided on or after the date DHCS receives and processes the Hospice NOE form.