Hospice - Medicare

If patient eligible for Medicare part A (In patient) who have terminal illness & life expectancy of six or less months, they can opt Hospice to manage their health. Patient not supposes to visit independent physician for terminal illness related treatment unless the hospice arrange it, front office should confirm before treat the patient.

If patient eligible for Medicare part B who has terminal illness, according to above rule patient not suppose to visit other independent physician, but in the below case it’s allowed.

GV and GW modifier

GW Modifier

Patient diagnosis not related to hospice diagnosis

GV Modifier

Patient diagnosis related to hospice diagnosis but a Professional service

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What is QMB / MQMB stands for?

In Medical billing or Healthcare industry The term QMB stands for Qualified Medicare Beneficiary & MQMB stands for Medicare Qualified Medicare Beneficiary. The term "QMB" or "MQMB" on the form indicates the client is a Qualified Medicare Beneficiary (QMB) or a Medicaid Qualified Medicare Beneficiary (MQMB). The Medicare Catastrophic Coverage Act of 1988 requires Medicare premiums, deductibles, and coinsurance payments to be paid for individuals who meet the following criteria: Important: Clients limited to QMB are not eligible for THSteps or THSteps-CCP Medicaid benefits. Note: Clients eligible for STAR+PLUS who have Medicare and Medicaid are MQMBs. Medicaid reimburses for the coinsurance and deductibles as well as Medicaid-only services for the MQMB client. QMBs do not receive Medicaid benefits other than Medicare deductible and coinsurance liabilities. MQMBs do qualify for Medicaid benefits not covered by Medicare in addition ...

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