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Hospice Site of Service Codes

Hospice agencies must report an HCPCS site of service location code along with each level of care revenue code to identify the type of service location where that level of care was provided.

If care is rendered at multiple locations, each location is to be identified on the claim with a corresponding HCPCS code. For example, routine home care may be provided for a portion of the billing period in the patient's residence and another portion in an assisted living facility. In this case, report one Revenue Code 651 (routine home care) line with HCPCS code Q5001 and the number of days of routine home care provided in the residence and another Revenue Code 651 (routine home care) line with HCPCS code Q5002 and the number of days of routine home care provided in the assisted living facility.

The HCPCS site of service location codes are listed in the table below.

HCPCS Codes

The HCPCS site of service location codes are listed in the table below.

Code Description
Q5001 Hospice care provided in patient's home/residence
Q5002 Hospice care provided in assisted living facility
Q5003 Hospice care provided in nursing long term care facility (LTC) or non-skilled nursing facility (NF)
Q5004 Hospice care provided in skilled nursing facility (SNF)
Q5005 Hospice care provided in inpatient hospital
Q5006 Hospice care provided in inpatient hospice facility
Q5007 Hospice care provided in long term care hospital (LTCH)
Q5008 Hospice care provided in inpatient psychiatric facility
Q5009 Hospice care provided in place not otherwise specified (NOS)
Q5010 Hospice home care provided in a hospice facility

Site of Service Location Notes

Q5001 is reported for hospice care provided in a private residence (e.g., house, apartment, town house).  Do not use Q5001 for congregate living situations (e.g., group home) (see Q5009).  Do not use Q5001 for nursing facility residents (see Q5003/Q5004).

Q5002 is reported for hospice care provided in an assisted living facility. Do not report Q5002 for nursing facility residents (see Q5003/Q5004).

Q5003 is to be used for hospice patients in an unskilled NF or hospice patients in the NF portion of a dually certified nursing facility, who are receiving unskilled care from the facility staff. Do not report Q5003 for patients in a SNF or in a SNF portion of a dually certified nursing facility (see Q5004).

Q5004 is to be used for hospice patients in a SNF, or hospice patients in the SNF portion of a dually certified nursing facility. There are 4 situations where this would occur:

  1. If the beneficiary is receiving hospice care in a solely-certified SNF.
  2. If the beneficiary is receiving general inpatient care in the SNF.
  3. If the beneficiary is in a SNF receiving SNF care under the Medicare SNF benefit for a condition unrelated to the terminal illness and related conditions, and is receiving hospice routine home care; this is uncommon.
  4. If the beneficiary is receiving inpatient respite care in a SNF.

Do not report Q5004 for patients in an unskilled NF or patients in a NF portion of a dually certified nursing facility. If a beneficiary is in a NF but doesn’t meet the criteria above for Q5004, report Q5003, for a long term care nursing facility.

NOTE: Some facilities are dually certified as a SNF and a NF; the hospice will have to determine what level of care the facility staff is providing (skilled or unskilled) in deciding which type of bed the patient is in, and therefore which code to use. When a patient is in the NF portion of a dually certified nursing facility, and receiving only unskilled care from the facility staff, Q5003 should be reported. Note that general inpatient care (GIP) that is provided in a nursing facility can only be given in a SNF, because GIP requires a skilled level of care.

Q5005 is reported for the hospice care provided in the acute care hospital.

Q5006 is reported for the GIP or respite care provided in the inpatient hospice facility. Do not report Q5006 when routine home care (RHC) or continuous home care (CHC) is provided at a hospice facility (see Q5010).

Q5007 is reported for hospice care provided in a long term care hospital.

Q5008 is reported for hospice care provided in an inpatient psychiatric facility.

Q5009 is reported for the hospice care provided in locations which are not already spelled out in one of the other site of service codes.  For example, Q5009 would be used for patients in congregate living facilities (e.g., group home) or for those patients who are homeless. 

Q5010 is reported for the when RHC or CHC is provided at a hospice residential facility or a hospice facility which is also certified to provide inpatient care. Do not report Q5010 when GIP or respite care is provided in the hospice facility (see Q5006).

Edits

Hospice claims submitted for services provided in non-covered settings will RTP. Claims will not be paid if the following level of care codes are reported with the site of service codes listed below. 

GIP level of care (revenue code 0656): Claims for GIP days will RTP if the following HCPCS site of service location codes are reported on the same line:

  • Q5001 (Patient's home/residence)
  • Q5002 (Assisted living facility)
  • Q5003 (Nursing LTC facility of non-SNF)
  • Q5010 (Hospice home care)

Respite level of care (revenue code 0655): Claims for respite days will RTP if the following HCPCS site of service location codes are reported on the same line:

  • Q5001 (Patient's home/residence)
  • Q5002 (Assisted living facility)
  • Q5010 (Hospice home care)

CHC level of care (revenue code 0652): Claims for CHC days will RTP if the following HCPCS site of service location codes are reported on the same line:

  • Q5004 (Skilled nursing facility)
  • Q5005 (Inpatient hospital)
  • Q5006 (Inpatient hospice)
  • Q5007 (LTC hospital)
  • Q5008 (Inpatient psychiatric facility)

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Disclaimer: This job aid was prepared as a service to the public and is not intended to grant rights or impose obligations. This job aid may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.

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