MedicaidBilling CodesHigh impact
[Ohio] Hospice Per Diem Billing
CareSource·OH · Palliative Care·Claims & Billing
Effective date
Feb 16, 2026
We identified it
Jun 13, 2026
Summary
CareSource Ohio Medicaid has clarified hospice billing requirements to reduce incorrect submissions. All hospice services must be billed on UB-04 forms except nursing facility room and board (T2046), which requires CMS-1500 forms with specific facility information and NPIs.
Action Required
Immediately: Billing team must update hospice billing workflows to use UB-04 forms (Type of Bill 081X/082X) for all hospice services except nursing facility room and board. For T2046 (nursing facility room and board), use CMS-1500 forms and include facility name in Box 32 and NPI in Box 32a. Add county codes and value codes 61 or G8 to all per diem services. For ventilator claims, include facility name and NPI in Box 80 and diagnosis code Z99.11. Claims not following this guidance will be denied.