HOSPICE OF CHARLES COUNTY It is the policy of Hospice to provide the following services for patients covered under the Medicare/Medicaid/Champus Benefit. COVERED SERVICES o Nursing care o Medical social services o Physician services (related to terminal illness) o Counseling services by Hospice personnel o Certified Nursing Assistant (CNA) and homemaker services o Physical therapy, occupational therapy, speech therapy o Bereavement counseling and follow-up o Volunteer support services o Medications related to the terminal diagnosis for palliation of symptoms which are included in the Hospice of Charles County formulary o Durable medical equipment as needed for patient comfort o Laboratory services necessary for palliative care o Spiritual care All services and treatments rendered are by the Plan of Care which is determined by the Interdisciplinary Team. All services must be pre-authorized by the IDT. SERVICES WHICH REQUIRE PRE-AUTHORIZATION • Surgery •
Major diagnostic workups
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CT scans/MRI
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Respiratory support (except oxygen and nebulizer treatments)
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Liquid oxygen and oxylite
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Renal Dialysis
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Total Parenteral Nutrition (TPN)
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Radiation therapy
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Chemotherapy
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Transfusion of blood and/or blood components
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Specialized beds
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Gamma knife procedure
Effective date: January 6, 1997 FINAL 2/16/2021
