MedicaidAdministrativeMedium impact
North Carolina Medicaid: Submitting hospice claims for members in SNFs
UnitedHealthcare·NC · Palliative Care·State news
Effective date
Feb 10, 2026
We identified it
Mar 1, 2026
Summary
North Carolina Medicaid has clarified billing procedures for hospice claims when members are in skilled nursing facilities. Only hospice providers should bill for room and board services using specific revenue codes, then reimburse the SNF directly to avoid duplicate claim denials.
Action Required
Immediately: Hospice billing teams must ensure only they (not SNFs) submit room and board claims to UnitedHealthcare Community Plan of North Carolina using revenue codes 0658 (intermediate care) or 0659 (skilled care). Update billing protocols to use monthly frequency with correct facility and attending provider NPIs. Coordinate with SNF partners to prevent duplicate billing that results in claim denials.