UnitedHealthcareMedium ImpactAdministrative
North Carolina Medicaid: Submitting hospice claims for members in SNFs
Published March 1, 2026Effective February 10, 2026
AI 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.
Plan Types
Medicaid
States
NC
Specialties
palliative-care