Hospice Billing Services
Hospice billing is a high-stakes race against the clock. Our hospice billing services help agencies eliminate NOE delays, reduce denials, and maximize Medicare reimbursements while staying fully compliant.
Hospice Performance Benchmarks
These results reflect the real impact of our hospice billing services across U.S. hospice agencies, showing improvements in claim speed, accuracy, and overall revenue performance.
Matrix
Industry Avg
Revix MD Standard
NOA Submission Speed
4.2 Days
<24 Hours
First-Pass Clean Claim Rate
86%
97.4%
Provider-Liable Days
4.5%
0.0%
Days in A/R (Hospice)
48 Days
<29 Days
GIP Audit Pass Rate
71%
100%
Specialized Expertise
Why Specialized Hospice RCM Matters
Generic hospice billing companies often overlook the unique Two-Tier Routine Home Care payment system and the catastrophic financial impact of out-of- sequence claim rejections.
Our hospice billing specialists follow CMS guidelines and Medicare compliance standards to ensure accurate, audit-ready claims.
The 5-Day NOE Guarantee
Medicare requires the Notice of Election (NOE) to be filed and accepted within 5 calendar days. Revix MD guarantees submission within 24 hours using real-time DDE verification, eliminating provider-liable penalties.
The HOPE Tool Transition
We ensure your clinical update visits (HUVs) are perfectly synchronized with your billing claims, protecting your 4% HQRP payment adjustment from missing or misaligned HOPE data.
Sequential Billing Protection
A single rejected claim in a sequence can halt your entire revenue stream. Our proprietary pre- scrubbing engine identifies MA40 remark code risks before they reach the MAC.
Hospice Billing Services We Offer
End-to-End Hospice Billing Services
We provide complete billing coverage for every phase of hospice and palliative care, including hospice RCM, palliative care billing, and end-of-life care billing from admission through discharge.
Medicare Hospice
Per Diem & Two-Tier RHC Management
We manage the complex Two-Tier RHC payment system, ensuring your claims accurately transition from the High rate (Days 1–60) to the Low rate (Day 61+) without technical denials.
Service Intensity Add-on (SIA): We capture every billable RN and Social Work visit during the last 7 days of life.
Audit Defense
GIP & CHC Audit Defense
General Inpatient and Continuous Home Care are primary targets for hospice ADR audits. We audit your clinical documentation to ensure it supports crisis-level intensity.
2026 CHC Rate: $69.76/hour. We track hourly documentation in real-time to ensure you meet the 8-hour minimum.
Live Discharge
Revocation & NOTR Billing
We file the Notice of Termination/Revocation (NOTR) within 2 days of discharge and handle complex final claim adjustments ensuring accurate Discharge Status Codes.
Medicaid & Palliative
Pediatric Concurrent Care & Palliative E/M
We manage state-specific per diems and election processes, plus maximize palliative care reimbursement utilizing E/M codes (99202–99215) and the G2211 complexity add-on.
Audit-Ready Compliance: ADR & RAC Defense
In 2026, Targeted Probe and Educate (TPE) audits focus on the “6-month prognosis” narrative. Revix MD provides a hospice ADR audit defense that starts at the point of admission.
F2F Attestation Tracking
CMS now allows Face-to-Face attestations to be part of the clinical note. We audit these notes to ensure they contain the specific signature, date, and narrative requirements to survive high-stakes reviews.
Monthly Cap Room Reports
We provide monthly Cap Room reports, alerting your CFO to potential overpayment penalties well before the October reconciliation deadline — protecting your agency from unexpected Medicare clawbacks.
CHC Hourly Rate
$69.76/hr
HQRP Non-Compliance Penalty
−4%
NOE Submission Window
5 Days
Revix MD NOE Speed
<24 Hrs
Seamless 30-Day Hospice Onboarding
Census & NOE Audit
We review your active patient list to ensure all current elections are compliant and all NOEs are on file with the MAC.
EMR Integration
Deep-link synchronization with your EMR (WellSky, MatrixCare, Homecare Homebase) to automate NOE, NOTR, and SIA capture.
Clinical-to-Billing Sync
We train your clinical team on the HOPE tool documentation markers and SIA visit logging requirements.
Execution
Go-live with 24-hour NOE submissions and real-time Cap Room tracking from day one.
What Hospice Leaders Are Saying
Revix MD eliminated our provider-liable days. Their mastery of the 5-day NOE rule saved our agency thousands. We no longer worry about missed deadlines or technical denials.
Sarah J. — Executive Director, Heritage Compassionate Care
Their team transformed our GIP billing process. We’ve seen a 98.2% clean-claim rate and total protection during ADR audits. Our cash flow is finally stable.
Mark T. — CFO, Unity Hospice & Palliative Group
Transitioning to palliative care was seamless with Revix MD. They maximized our physician fee schedule reimbursements, allowing us to expand services while remaining compliant.
Dr. Elena R. — Medical Director, Blue Ridge Palliative Services
Secure Your Agency's Financial Integrity.
Let Revix MD handle the technical complexities of hospice and palliative care billing while you focus on what matters most.
FAQs
Can we bill for a Social Worker visit on the same day as an RN visit during the SIA period?
Yes. Both RN and Social Work visits provided during the last 7 days of life (at the RHC level) are billable under the Service Intensity Add-on (SIA), provided they are for direct patient care rather than administrative tasks.
How do you handle hospice live discharge billing?
We file the NOTR within 48 hours of discharge and scrub the final claim for the correct status code. This prevents the “open election” errors that lead to Medicare recoupment and patient transfer conflicts.
What is the Medicare Hospice Cap for 2026?
The aggregate cap is $35,361.44. Revix MD monitors your “Cap Room” monthly, providing a trajectory report so you can manage your admissions and avoid unexpected Medicare clawbacks.
How do you handle Medicaid hospice billing services?
We manage the state-specific election forms and per-diem room-and-board rates. Since Medicaid often acts as the secondary payer for nursing home residents, we ensure the “95% of the room and board” rate is captured correctly.
What is the current rate for Continuous Home Care (CHC)?
For 2026, the CHC hourly rate is $69.76. We track your hourly documentation in real-time to ensure you meet the 8-hour minimum requirement for a valid CHC day.
How do you manage the HOPE tool billing compliance?
We ensure that the clinical data collected during the initial and update visits (HUVs) matches the “from” and “to” dates on your claims. This prevents the 4% payment penalty associated with non-compliance in the HQRP program.