MedicaidAdministrativeHigh impact
Attention Provider Type 64 (Hospice): Service Limitations Added in the Medicaid Management Information System (MMIS) for Hospice Revenue Codes
Nevada Medicaid·NV · Palliative Care·Provider Enrollment
Effective date
Feb 1, 2019
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has implemented service limitations for hospice revenue codes that were previously paying in error. Claims exceeding daily limits will now be denied or reduced, and past overpayments since February 2019 will be automatically reprocessed and recouped.
Action Required
Immediately: Hospice providers (PT 64) must update billing practices to comply with daily unit limitations - 1 unit per day for revenue codes 0650, 0651, 0655, 0656, and maximum 24 units per day for code 0652. Review upcoming remittance advice for automatic claim reprocessing results and potential recoupments dating back to February 2019. Prepare for possible appeals if reprocessed claims are denied.