Primary Attending Physician
The primary (attending) physician is chosen by the patient and listed as the hospice attending physician on the Medicare claim form.
Billing for Care Related to the Terminal Diagnosis: Only the hospice primary (attending) physician can bill Medicare Part B for care related to the terminal diagnosis. Use the applicable CPT©E/M code for the service, add the GV modifier, and submit with the ICD-10 code for the hospice diagnosis.
Consulting (or Secondary) Physician
If you are not the physician designated as the hospice primary (attending) physician on the Medicare Election of Benefits, you are considered a consulting (secondary) physician for billing purposes.
- A "Physician Consulting Agreement" must be signed before the care is provided. This allows Trustbridge to bill Medicare for your services and meet regulatory requirements to reimburse physicians. Email contractadmin@trustbridge.com or call 227.5188.
- Only hospice can bill Medicare for physician services related to the terminal illness (except those provided by the hospice attending physician, as defined above). Bills submitted to Medicare B will be denied.
- The physician bills Trustbridge using applicable CPT©E/M codes for both professional and technical components using a CMS 1500 form. Hospice bills Medicare Part A and reimburses the physician according to the terms of the "Physician Consulting Agreement."
Physician Services NOT Related to the Hospice Diagnosis
Any physician may provide care to a hospice patient for diagnoses that are NOT related to the terminal illness. Use the applicable CPT©E/M code for the service, add the GW modifier, and submit with the appropriate ICD-10 codes.
Billing for Other Services Related to the Terminal Diagnosis
Only hospice can bill Medicare for ANY service related to the terminal diagnosis (except for hospice attending physician services, as described above).
Medications, diagnostic tests and procedures must be pre-authorized by Trustbridge. Authorization is obtained from the team supervisor caring for the patient. Payment will be based on the provider's billing agreement with Trustbridge.
