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NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 

Hospice Services

DMA Clinical Policy and Programs
919-855-4380
Fax 919-715-9025

The Medicaid hospice benefit is a coordinated program of services that provides medical, supportive and palliative care to terminally ill recipients and their families/caregivers. 

Program coverage complies with 10A NCAC 13K, North Carolina Rules Governing the Licensure of Hospice, N.C. General Statute 10 G.S. 131E-201, and Federal Code of Regulations 42 CFR 418. 

The services are provided according to a care plan established by an interdisciplinary team of medical professional and social support staff employed by or, under contract with the hospice agency, as allowed by the Centers for Medicare and Medicaid Services (CMS).  Each care plan describes the method of providing services to meet the recipient’s medical, psychosocial and spiritual needs.  Services are provided in private homes, hospice residential care facilities, adult care homes, or in nursing facilities and hospitals when there is a contractual arrangement between the hospice and the facility.  Hospice participation may limit Medicaid reimbursement of other services.  The hospice benefit covers all care pertaining to the terminal illness.

For service requirements, coverage criteria and limitations, refer to Clinical Coverage Policy #3D, Hospice Services.

Medicaid Bulletins

For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.

Hospice Fee Schedules

Forms

To see forms that apply to all providers, please visit our Provider Forms page.

 

 

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