Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1130 - HOSPICE SERVICES
PAYMENT FOR HOSPICE CARE
Section 1130.72 - Payment for physicians' services
Current through Register Vol. 54, No. 12, March 23, 2024
(a) The following services performed by hospice physicians are included in the level of care rates paid for a day of hospice care:
(b) For physicians' services not described in subsection (a), payment will be made to the hospice in accordance with the MA Program Fee Schedule.
(c) Services of the recipient's attending physician are paid directly to that physician in accordance with the MA Program Fee Schedule if the physician is not an employe of the hospice or providing services under arrangement with the hospice.
(d) Services provided to treat a condition that is clearly unrelated to the terminal illness are not considered hospice services. The services are compensable to the appropriate provider in accordance with the applicable MA Program regulations.