Hospice Billing for Nursing Facility Room and Board (T2046), Health Care Isolation Centers and Ventilator Weaning Services

Nursing Facility Room and Board (T2046)

Hospice providers billing for nursing facility room and board must bill using the HCFA (CMS 1500). The Ohio Medicaid ID and name of the nursing facility in which the services were delivered must be placed in box 32 and the NPI related to the nursing facility must be placed in 32a. 

Healthcare isolation center (HCIC) and ventilator and ventilator weaning claims

HCIC (in other words, 167, 241, 242, 243 or 249), ventilator and ventilator weaning (in other words, 0410, 0419) claims must be billed using the UB04 Institutional Form. 

When billing HCIC and ventilator weaning claims, the provider is required to include the Ohio Medicaid ID and name of the nursing facility in which the services were delivered in box 80 (remark code). In addition, when billing for ventilator and/or ventilator weaning services, the diagnosis code Z99.11 must be included

Any claims for nursing faculty room and board, HCIC, or ventilator/ventilator weaning that do not meet the instructions in this guidance may be denied and require the submission of an adjusted claim.

Note: The current listing of facilities with Medicaid IDs can be found on the Ohio Department of Medicaid (ODM) website at https://tinyurl.com/mvr83def under Nursing Facility Rates. This information will allow claims to be properly priced avoiding backend work and delay. 

UB — Institutional valid bill types:

• 081x — Special Facility Hospice (non-hospital based)
• 082x — Special Facility Hospice (hospital based)

Value codes:

• 61 — Location Where Service is Furnished (HHA and Hospice)
• G8 — Facility where inpatient hospice service is delivered

Note: When value code G8 is billed, the NPI of the facility, along with their name, must be billed in box 80 remarks on UB

ODM specified Social Security Administration (SSA)/State County code = SSA/State County code listed on the published ODM Compliant & Non-Compliant Census Core-Based Statistical Area rate grids.