22.2 Benefits, Limitations, and Authorization RequirementsThe CSHCN Services Program may reimburse for hospice services for clients. Hospice care includes palliative care for clients with a prognosis of 6 months or less. Services must be related to palliative care for the terminal diagnosis and may include any or all of the following services: direct care, respite, durable medical equipment, supplies, and medications prescribed for the terminal illness. Direct care services may include:
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• The hospice benefit does not cover curative care for the terminal diagnosis. Coverage for conditions unrelated to the terminal illness is unaffected. If nutritional supplements are the client's sole source of nutrition, the supplements are included in the per diem rate. Total parenteral nutrition (TPN) provided to a client on hospice services may be reimbursed separately according to the TPN policy. Refer to: Section 25.5.2, "Benefits, Limitations, and Authorization Requirements" for TPN benefits, limitations, and authorization requirements. Hospice and home health services may not be reimbursed on the same date of service, with the exception of the initial date of service when the client is being discharged from home health service and admitted to hospice service. |
Skilled nursing services
