Medicaid Benefits: Online Database

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Benefits by Service: Hospice Care (October 2008) Definition/Notes

Note: Totals include 50 states and D.C.

"Benefits Covered" Totals

"Benefits Not Covered" Totals

Is the benefit covered?

Is there a co-payment requirement?

Yes: 0

No: 48

Is the Benefit Covered?	Copayment Requirement	Prior Approval Requirement	Coverage Limitations	Reimbursement Methodology	Populations Covered

Alabama
Yes		Yes		Prospective rates based on Medicare methodology	CN
Alaska
Yes		Yes	210 days unless additional days certified by physician	Prospective rates based on Medicare methodology	CN
Arizona
Yes				Prospective rates based on Medicare methodology	CN & MN
Arkansas
Yes			Two 90-day periods with additional 60-day periods as necessary	Prospective rate using Medicare wage index	CN & MN
California
Yes		Yes	Services must generally comply with Medicare guidelines	Prospective rates based on Medicare methodology	CN & MN
Colorado
Yes				Prospective rates based on Medicare methodology	CN
Connecticut
No
Delaware
Yes				Prospective rates based on Medicare methodology	CN
District of Columbia
Yes			Two 90-day periods and one 30-day period with additional 30-day periods as necessary	Prospective rates based on Medicare methodology	CN & MN
Florida
Yes				Prospective rates based on Medicare methodology	CN & MN
Georgia
Yes			Two 90-day periods and one 30-day period with physician certification	Prospective regional rates based on Medicare methodology	CN
Hawaii
Yes		Yes	Two 90-day periods plus one 60-day period	Prospective payment based on Medicare methodology and rates	CN & MN
Idaho
Yes			Services limited to Enhanced Plan and tMedicare/Medicaid Coordinatd Plan - See state-specific FN	Prospective rates based on Medicare methodology	CN
Illinois
Yes				Prospective rates based on Medicare methodology	CN & MN
Indiana
Yes		Yes		Prospective rates based on Medicare methodology	CN
Iowa
Yes				Prospective rates based on Medicare methodology	CN & MN
Kansas
Yes				Prospective rates based on Medicare methodology	CN & MN
Kentucky
Yes			Limited to non-institutional care, two 90-day periods and one 30-day period with additional periods as necessary	Prospective rates based on Medicare methodology	A, B, C & D - See state-specific FN
Louisiana
Yes			Two 90-day periods with additional 60-day periods as necessary	Prospective rates based on Medicare methodology	CN & MN
Maine
Yes			Two 90-day periods and additional 60-day periods as necessary	Prospective per diem or hourly rates based on Medicare methodology	CN & MN
Maryland
Yes			Two 90-day periods and one 30-day period with additional periods as necessary	Prospective rates based on Medicare methodology	CN & MN
Massachusetts
Yes				Prospective rates based on Medicare methodology	CN & MN
Michigan
Yes				Prospective rates based on Medicare methodology	CN & MN
Minnesota
Yes			Two 90-day periods with additional 60-day periods as necessary	Prospective rates based on Medicare methodology	A & B - See state-specific FN
Mississippi
Yes			Two 90-day periods with additional 60-day periods as necessary	Prospective rates based on Medicare methodology	CN
Missouri
Yes			Two 90-day periods and one 60-day period with additional periods as necessary	Prospective rates based on Medicare methodology	CN & MN
Montana
Yes				Prospective rates based on Medicare methodology	A & B - See state-specific FN
Nebraska
Yes		Initiation of care		Prospective rates based on Medicare methodology	CN & MN
Nevada
Yes				Prospective rates based on Medicare methodology	CN
New Hampshire
No
New Jersey
Yes			Two 90-day periods and one 30-day period with additional periods as necessary, 24 therapeutic leave days per year	Prospective rates based on Medicare methodology	CN
New Mexico
Yes		Yes		Prospective rates based on Medicare methodology	CN
New York
Yes				Prospective rates based on Medicare methodology	CN & MN
North Carolina
Yes				Prospective per diem rates based on Medicare methodology	CN & MN
North Dakota
Yes				Prospective rates based on Medicare methodology	CN & MN
Ohio
Yes				All-inclusive rate per day for applicable level of care	CN
Oklahoma
No
Oregon
Yes				Prospective rates based on Medicare methodology	A & B - See state-specific FN
Pennsylvania
Yes				Prospective rates based on Medicare methodology	CN & MN
Rhode Island
Yes			210 day maximum coverage	Prospective rates based on Medicare methodology	CN & MN - see state-specific FN
South Carolina
Yes			Two 90-day periods and one 30-day period with additional periods as necessary	Prospective rates based on Medicare methodology	CN
South Dakota
Yes			Beneficiary must make an election statement	Prospective rates based on Medicare methodology	CN
Tennessee
Yes					A & B - See state-specific FN
Texas
Yes			One 6-month period with additional periods as necessary	Prospective rates based on Medicare methodology	CN
Utah
Yes			B - respite care and services for convenience of beneficiary or family not covered	Prospective rates based on Medicare methodology	A, B & C - See state-specific FN
Vermont
Yes				Fee for service	A & B - See state-specific FN
Virginia
Yes		Yes		Prospective rates based on Medicare methodology	CN & MN
Washington
Yes				Prospective rates based on Medicare methodology, rates vary geographically	CN & MN
West Virginia
Yes				Prospective rates based on Medicare methodology	A & B
Wisconsin
Yes				Prospective rates based on Medicare methodology	CN & MN
Wyoming
Yes				Prospective rates based on Medicare methodology	CN
American Samoa
No
Guam
No
Northern Mariana Islands
No
Puerto Rico
No - see territory-specific FN
Virgin Islands
No

Definition/Notes: Link to Hospice Care Footnote


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