MedicaidBilling CodesMedium impact
23-582m Avoid Claims Delays: SNFs Should Not Bill Room and Board for a CalViva Health Medi-Cal Member on Hospice
Health Net·CA · Palliative Care·Prior Authorization
We identified it
Jun 20, 2026
Summary
SNFs must stop billing room and board charges for CalViva Health Medi-Cal members receiving hospice care. Only hospice providers should bill for room and board using revenue code 0658, while hospice providers reimburse SNFs directly at negotiated rates.
Action Required
Immediately: Billing teams at SNFs must stop billing room and board charges for CalViva Health Medi-Cal members on hospice care. Update billing system to prevent R&B claims with revenue code 0658 for hospice patients. Coordinate with hospice providers for direct reimbursement arrangements. Failure to comply will result in claims delays and denials.