New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 325 - SPECIALTY SERVICES
Part 4 - HOSPICE CARE SERVICES
Section 8.325.4.15 - NONCOVERED SERVICES
Current through Register Vol. 35, No. 18, September 24, 2024
Hospice services are subject to the limitations and coverage restrictions that exist for other medicaid services. See 8.301.3 NMAC, General Noncovered Services. Medicaid does not cover the following hospice services.
A. Core services furnished by nonemployees. Core services when furnished routinely by non-employees or contracted staff are not covered by medicaid. A hospice can bill only for contracted staff necessary to supplement hospice employees in meeting recipient needs during periods of peak patient loads.
B. Bereavement counseling furnished to families after a recipient's death is a required hospice service, however, hospice agencies are not paid an additional amount for furnishing these services.
C. Inpatient respite care for more than five consecutive days. After five days, additional inpatient respite care is reimbursed as routine home care. Respite care cannot be furnished if the recipient lives in a long-term care facility.
D. Hospice services furnished by nondesignated hospices are not a covered benefit.
