Palliative Care Billing

Many Palliative Care programs struggle financially. One key component of sustainability involves having an effective Medicare Part B billing process. Here are 5 do’s and don’ts that will lift the profitability of your community-based palliative program.

DO Streamline Documentation

Accurate & complete documentation is essential to minimize claim denials. Providers need a simple (read “low burden”) process that allows them to efficiently record patient encounters and then seamlessly transfer this information to the billing department for processing. Your EHR may have tools that support billing and documentation; if not look for alternatives. Efficient documentation combined with a quicker claims process will have a significant impact on cash flow.

DO Utilize Available Palliative Care Billing Codes

Over the past two years, Medicare has added several new codes that directly benefit Palliative Care. ACP (Advance Care Planning) codes allow providers to bill for helping patients make decisions about the care they want if and when they become unable to speak for themselves. Additionally, Non-Face-To-Face codes allow providers to bill for prolonged evaluation and management services before and/or after direct patient care. Both of these new codes reimburse for care that is essential to delivering person-centered Palliative Care, yet many agencies are not fully utilizing this capability. For a full set of appropriate ACP and Non-Face-To-Face codes, click here.

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