There are four code families that run hospice billing. The first one is revenue codes that identify the level of care and the second is HCPCS Q-codes that identify where care was delivered. As for the third, it includes CPT and G-codes for physicians and the last are ICD-10 codes for the terminal diagnosis.
If you get any one of these wrong, it does more than just underpay, it can stall every claim behind it in the sequential billing cycle. This blog will cover the hospice billing codes that are commonly used and are used on nearly every claim. We will teach you how they pair with each other and the FY 2026 changes.
Hospice Codes at a Glance
| Code Family | What it Identifies | Range |
| Revenue Codes | Level of Care | 0651, 0652, 0653, 0654 |
| HCPCS Q-Codes | Site of Service | Q5001-Q5010 |
| CPT/G-Codes | Physician Services | G0182, 99377, 99378, G0299 |
| ICD-10-CM | Terminal Diagnosis | Condition-Specific |
One thing to note is that every hospice claim line carries a revenue code and a matching Q-code with it. The other two families are used depending on who provided the service and the reason.
FY 2026 Hospice Rates and Rule Changes
The 2.6% payment increase finalized by CMS for FY 2026 (October 1, 2025) is approximately $750 million in extra national hospice payments. The aggregate cap increased to $35,361.44 and the routine home care on days 1-60 is $230.83 per day, up to wage index adjustment.
There are two changes to consider other than the rates. Hospices with inadequate performance at HQRP are penalized with a 4% reduction in the 2.6% gain, resulting in a loss of 1.4% in performance. Beginning in FY 2026, the HOPE instrument is being replaced by the HIS, which alters clinical data collected and the timing of collection.
Hospice Revenue Codes and the Four Levels of Care
| Revenue code | Level of care | Unit basis |
| 0651 | Routine Home Care (RHC) | 1 unit = 1 day |
| 0652 | Continuous Home Care (CHC) | 15-minute increments |
| 0655 | Inpatient Respite Care (IRC) | 1 unit = 1 day |
| 0656 | General Inpatient Care (GIP) | 1 unit = 1 day |
| 0658 | Room and board, LTC facility | 1 unit = 1 day |
Routine and Continuous Home Care
Routine home care accounts for the large majority of hospice days and is the default level. It is billed under the revenue code (0651) as whole days. There is also a higher rate for days 1-60 of the selection.
As for the continuous home care, it is the crisis level where nursing care is delivered at home during a period of acute symptom management. It is the one level that is not billed in days. 0652 is reported in 15-minute increments, with a minimum of 8 hours of predominantly nursing care in a 24-hour period. Also, there are units that you should know about. Eight hours equals 32 units, 24 hours equals 96 units. Miscounting these is among the most common CHC billing errors, and one that automated claim scrubbing catches before submission.
Hospice HCPCS Codes (Q5001-Q5010)
The hospice HCPCS codes are used to identify where care was delivered and pair with the revenue code on the same claim line.
| HCPCS code | Site of service |
| Q5001 | Patient’s home or residence |
| Q5002 | Assisted living facility |
| Q5003 | Long-term care or non-skilled nursing facility |
| Q5004 | Skilled nursing facility (SNF) |
| Q5005 | Inpatient hospital |
| Q5006 | Inpatient hospice facility |
| Q5007 | Long-term care hospital |
| Q5008 | Inpatient psychiatric facility |
| Q5009 | Place not otherwise specified |
| Q5010 | Hospice residential facility |
Q5010 and Q5006: The Most Common Mix-Up
These two codes are related to hospice-owned buildings, thus the confusion. If routine or continuous home care is provided at a hospice residential facility, then Q5010 is applicable. If general inpatient or respite care is provided in an inpatient hospice facility, then Q5006 applies. If Q5010 is reported on a GIP or respite line then the claim will be returned, and RTP denial management before the next month’s claim process can prevent it.
Billing Care Across Multiple Locations
Don’t add the days when a patient moves between periods. Put one 0651 line for days at home with Q5001, and a second 0651 line with Q5002 for days in an assisted living facility. The unit count is on each line.
Matching Level of Care to Site of Service
Be vigilant that not every level of care can be delivered in every setting. Also, Medicare enforces the pairings automatically.
| HCPCS | RHC (0651) | CHC (0652) | Respite (0655) | GIP (0656) |
| Q5001 Home | Yes | Yes | No | No |
| Q5002 Assisted living | Yes | Yes | No | No |
| Q5003 LTC / non-skilled NF | Yes | Yes | Yes | No |
| Q5004 SNF | Yes | No | Yes | Yes |
| Q5005 Inpatient hospital | Yes | No | Yes | Yes |
| Q5006 Inpatient hospice facility | Yes | No | Yes | Yes |
| Q5007 LTC hospital | Yes | No | Yes | Yes |
| Q5008 Inpatient psychiatric | Yes | No | Yes | Yes |
| Q5009 Place not otherwise specified | Yes | Yes | Yes | Yes |
| Q5010 Hospice residential facility | Yes | Yes | No | No |
Hospice CPT and Physician Service Codes
Hospice per diems cover the agency’s services. However, physician work is billed separately and this is where most hospice CPT code questions arise.
Core Plan Oversight Codes
| Code | Description |
| G0182 | Hospice care plan oversight, 30+ minutes per calendar month |
| 99377 | Hospice care plan oversight, 15–29 minutes |
| 99378 | Hospice care plan oversight, 30+ minutes |
| G0299 | RN direct skilled nursing, 15-minute increments |
GV and GW Modifiers
Electing hospice waives Medicare Part B payment for services that are related to the terminal illness. So the modifier tells Medicare which bucket a physician service is part of.
- GV: The attending physician is not employed by or compensated by the hospice. Also, the service is related to the terminal diagnosis. Bill Part B with GV.
- GW: The service is not related to terminal diagnosis and without GW, Medicare denies the claim is instead covered under the hospice benefit.
Hospice ICD-10 Diagnosis Codes
The principal diagnosis on a hospice claim must be the condition that contributes the most to the terminal prognosis along with related conditions also reported.
| ICD-10 code | Terminal diagnosis |
| G30.9 | Alzheimer’s disease, unspecified |
| F03.90 | Unspecified dementia without behavioral disturbance |
| I50.9 | Heart failure, unspecified |
| J44.9 | COPD, unspecified |
| I63.9 | Cerebral infarction, unspecified |
| N18.6 | End stage renal disease |
| C34.90 | Malignant neoplasm of lung, unspecified |
Diagnoses Medicare Will Not Accept as Principal
This is the rule that agencies are caught by. CMS does not recognize non-specific symptom codes, such as “debility” or “adult failure to thrive,” as principal hospice diagnoses, and claims with these codes are returned. These conditions may be present as associated diagnoses, but the diagnosis for the actual terminal condition affecting the prognosis must be named in the principal code.
The Bottom Line on Hospice Codes
The majority of hospice denials relate to a mismatch, or an invalid site of service, CHC units scheduled as days instead of quarter hours, or a principal diagnosis that is too vague. The crossovers are developed into your claim scrubbing and most of the RTPs go down the drain.
For hospice agencies across the country who prefer to outsource their NOE filing, level-of-care coding and denial management, our hospice billing and coding services can do it for them.