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Generic hospice billing companies often overlook the unique “Two-Tier” Routine Home Care (RHC) payment system and the catastrophic financial impact of out-of-sequence claim rejections.
To prevent these costly errors, our hospice billing experts provide targeted hospice coding services, handling the intricate compliance and claims work that generic agencies frequently miss.
Medicare requires the Notice of Election (NOE) to be filed and accepted within 5 calendar days of the admission date. Revix MD guarantees submission within 24 hours of the election. We eliminate the “provider-liable” penalty by utilizing real-time DDE (Direct Data Entry) verification.
Effective October 1, 2025, the HOPE tool replaced the HIS. We ensure your clinical update visits (HUVs) are perfectly synchronized with your billing claims. This protects your 4% HQRP payment adjustment, which is at risk if HOPE data is missing or misaligned according to the Hospice Quality Reporting Program (HQRP) requirements.
A single rejected claim in a sequence can halt your entire revenue stream. Our proprietary pre-scrubbing engine identifies MA40 remark code risks (where admission and “from” dates mismatch after April 2026), preventing technical rejections before they reach the MAC.
We provide complete billing coverage for every phase of hospice and palliative care. Our hospice billing specialists manage hospice RCM, palliative care billing, and end-of-life care billing from admission through discharge.
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 provided during the last 7 days of life. Our system monitors the patient’s level of care (RHC) and clinical status to ensure these high-value add-ons are included on the final claim.
General Inpatient (GIP) and Continuous Home Care (CHC) are the primary targets for hospice ADR audits. We audit your clinical documentation to ensure it supports the crisis-level intensity required for the $69.76/hour CHC rate.
2026 CHC Rate: $69.76/hour. We track hourly documentation in real-time to ensure you meet the 8-hour minimum.
We file the Notice of Termination/Revocation (NOTR) within 2 days of discharge to release the patient’s record for other providers, preventing future claim conflicts.
Under the ACA, children can receive curative treatment alongside hospice. We manage this distinct billing pathway, ensuring curative and palliative claims are coded to prevent “duplicate billing” rejections. We also bridge the financial gap for patients not yet ready for the hospice benefit by maximizing palliative care reimbursement through E/M codes (99202–99215) and the G2211 complexity add-on for patients with chronic, life-limiting illnesses. Additionally, we ensure that NP and physician consultations are billed alongside the proper modifiers, protecting your margins as you expand your palliative reach. Our palliative care billing services cover physician fee schedule claims, facility billing, and complex multi-payer coordination for hospice agencies expanding into palliative programs.
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.
CMS now allows Face-to-Face (F2F) 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.
The aggregate cap for the 2026 cap year is $35,361.44. We provide monthly “Cap Room” reports, alerting your CFO to potential overpayment penalties well before the October reconciliation deadline.
For agencies trying to figure out which hospice billing company to trust with their revenue, our compliance-first approach means your billing is always survey-ready, not just fast.
Switching your hospice per diem billing requires a “zero-gap” transition to protect your active census.
See why hospice leaders across the U.S. trust Revix MD as their hospice billing consulting partner for compliance, revenue recovery, and audit defense.
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.
Dr. John Codwell — Codwell Family Foot Center
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.
Jouvonna Gray, NP — Get Well HealthCare Services
Transitioning to palliative care was seamless with Revix MD. They maximized our physician fee schedule reimbursements, allowing us to expand services while remaining compliant.
Amer Khan — Omali Diagnostic, LLC
Let Revix MD handle the technical complexities of hospice and palliative care billing while you focus on what matters most.
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.
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.
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.
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.
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.
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.
Outsourcing hospice billing services gives your agency access to certified hospice billing specialists who stay current on Medicare rule changes, HOPE tool updates, and payer-specific filing requirements. It reduces staffing overhead, eliminates NOE filing gaps, and typically improves clean-claim rates by 10 to 15 percent within the first 90 days.
Yes. Our hospice coding and modifier guidance covers ICD-10 diagnosis sequencing, revenue code assignment (including 651, 652, 655, 656, and 658), and CPT/HCPCS coding for physician services billed under the hospice benefit. All coding is reviewed by certified specialists before claim submission.
Medicaid hospice billing varies by state. Most state programs pay a per-diem room-and-board rate for patients in nursing facilities, typically set at 95% of the facility rate. Election forms, authorization processes, and billing timelines all differ from Medicare. Our team manages these state-specific requirements across all 50 states.
Start with their NOE turnaround. If they’re filing close to the 5-day Medicare deadline instead of well inside it, that’s a red flag. Beyond that, ask how they handle sequential billing errors, whether they track the aggregate cap monthly or just at year-end, and what their process looks like for GIP and CHC audit defense. You also want a company that works inside your EMR, whether that’s WellSky, MatrixCare, or Homecare Homebase, because a billing partner that can’t operate in your system will slow everything down during onboarding. Finally, ask about their transition plan for your active census. Switching billing companies mid-operation is risky, and the right partner will have a structured timeline to make sure nothing falls through the cracks.
