Hello
I am having a hard time getting an answer on this question from Medicare so reaching out to see if anyone else can help.
My provider bills for chronic care once a month while seeing following patients that are on Hospice. CPT codes that have been used are 99491, 99437, 99487,99489 with GW modifier. Medicare has started denying these claims for the Hospice patients. When I call Medicare for clarification Medicare directs me to Chapter 11 40.1.2, 40.1.3, 50- nowhere in there can I find that chronic care is not covered for patients that are on hospice. Medicare states that they made this change back in June 2024. I can't find anywhere that this change has been made. has anyone else had this issue and if so, what work arounds are working? or where I can find where it documented that this change has happened.
I am having a hard time getting an answer on this question from Medicare so reaching out to see if anyone else can help.
My provider bills for chronic care once a month while seeing following patients that are on Hospice. CPT codes that have been used are 99491, 99437, 99487,99489 with GW modifier. Medicare has started denying these claims for the Hospice patients. When I call Medicare for clarification Medicare directs me to Chapter 11 40.1.2, 40.1.3, 50- nowhere in there can I find that chronic care is not covered for patients that are on hospice. Medicare states that they made this change back in June 2024. I can't find anywhere that this change has been made. has anyone else had this issue and if so, what work arounds are working? or where I can find where it documented that this change has happened.