MedicaidReimbursementHigh impact
Fee-for-service hospice rates effective April 1, 2020 through June 30, 2020
Oregon Health Plan·OR · Palliative Care·Provider
Effective date
Apr 1, 2020
We identified it
Jun 20, 2026
Summary
Oregon Health Authority increased fee-for-service hospice reimbursement rates for revenue codes 658, 191, and 192 (nursing facility room and board on hospice) effective April 1, 2020 through June 30, 2020 as part of COVID-19 response. Billing teams must apply new per diem rates ($359.15 basic, $502.81 complex medical, $805.65 pediatric) and ensure correct revenue code selection based on hospice election day count (651 for days 1-60, 650 for day 61+, 652 for continuous home care).
Action Required
By April 1, 2020: Billing team must update hospice billing system with new per diem rates for revenue codes 658 ($359.15), 191 ($502.81), and 192 ($805.65) for nursing facility room and board claims. Implement logic to automatically select correct revenue code based on hospice election timeline: use 651 for RHC days 1-60, 650 for RHC day 61+, and 652 for continuous home care. Train billing staff on readmission rules—when readmitted within 60 days, count prior hospice days toward the 60-day threshold; when readmitted after 60+ days, reset to day 1 counting. Ensure all claims submitted April 1-June 30, 2020 reflect these rates. Verify billing software correctly populates CBSA codes in value code field 61 to ensure rates match the cost-based statistical area where care is furnished. Non-compliance will result in underpayment or claim denials.