CSHCN Services Program 2010 > Hospice > Claims Information

22.3 Claims Information

Claims for hospice services must be billed using the following revenue codes:

Hospice services must be submitted to TMHP in an approved electronic format or on the
UB-04 CMS-1450 paper claim form. Providers may purchase UB-04 CMS-1450 paper claim forms from the vendor of their choice. TMHP does not supply the forms.

When completing a UB-04 CMS-1450 paper claim form, all required information must be included on the claim, as TMHP does not key any information from claim attachments. Superbills, or itemized statements, are not accepted as claim supplements.

Refer to: Chapter 37, "TMHP Electronic Data Interchange (EDI)" for information about electronic claims submissions.

Chapter 5, "Claims Filing, Third-Party Resources, and Reimbursement" for general information about claims filing.

Section 5.7.1.7, "Instructions for Completing the UB-04 CMS-1450 Paper Claim Form" for instructions on completing paper claims. Blocks that are not referenced are not required for processing by TMHP and may be left blank.