New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-W - Former Division of Human Services
Chapter He-W 500 - MEDICAL ASSISTANCE
Part He-W 544 - HOSPICE SERVICES
Section He-W 544.16 - Payment for Physicians' Services

Universal Citation: NH Admin Rules He-W 544.16

Current through Register No. 40, October 3, 2024

(a) If a recipient's attending physician, who is not an employee of the designated hospice or providing services under arrangement with the designated hospice, provides physician services related or unrelated to the treatment of the terminal illness:

(1) These physician services shall not be considered as part of the per diem rate described in He-W 544.13; and

(2) He or she shall bill for these physician services separately and be reimbursed at the regular physician services rate in accordance with He-W 531.

(b) If a recipient does not have an attending physician at the time of electing the hospice benefit, t he medical director of the designated hospice provider or the physician member of the hospice interdisciplinary group shall:

(1) Be the recipient's attending physician; and

(2) Bill and receive payment as follows:
a. Physician services that are related to the treatment of the terminal illness shall be considered hospice services and be included in the per diem rate described in He-W 544.13; and

b. Physician services that are unrelated to treatment of the terminal illness shall be considered physician services and shall be billed separately by the physician and be reimbursed at the regular physician services rate in accordance with He-W 531. These services shall not be billed by the hospice provider.

(c) If a recipient's attending physician, who is not an employee of the designated hospice or providing services under arrangement with the designated hospice, requests through an order that the medical director or hospice physician provide physician services not described in He-W 544.09(b) (3) , these physician services shall be billed as in (a) (1) and (2) above.

#9726-A, eff 7-1-10

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