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Billing when GIP is being provided at a contracted facility in another county with different rates

  • 1.  Billing when GIP is being provided at a contracted facility in another county with different rates

    This message was posted by a user wishing to remain anonymous
    Posted 02-06-2026 01:12 PM
    This message was posted by a user wishing to remain anonymous

    Hey friends!

    The primary address tied to our state license and Medicare certification is in a rural county. We contract with a facility in a neighboring county for GIP care-- that county is not considered rural, and the two counties have different Medicare reimbursement rates.

    I'd like to hear your thoughts about this scenario. Are we okay to bill under the GIP facility address and thus receive that different reimbursement rate? Or do we need to work with our EMR to figure out a way to bill under the home county rural rate when patients are receiving GIP care in that facility?

    Hope that makes sense. Thank you!



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  • 2.  RE: Billing when GIP is being provided at a contracted facility in another county with different rates

    Posted 02-07-2026 11:10 PM

    Straight from the Medicare Claims Processing Manual Chapter 11

     

    G8 Facility where Inpatient Hospice

    Service is Delivered (General

    Inpatient and Inpatient Respite Care).

    MSA or Core Based Statistical Area (CBSA) number

    (or rural State code) of the facility where inpatient

    hospice services are delivered.

    Hospices must report value code G8 when billing

    revenue codes 0655 and 0656.

     

    You will report a G8 value code on the claim and the corresponding CBSA code to the facility....It will only pay you the rate associated with the facility CBSA code for the time period that they are in facility.

     

    Melinda A. Gaboury, COS-C

    Chief Executive Officer

    Healthcare Provider Solutions, Inc.

    402 BNA Drive, Suite 212

    Nashville, TN  37217

    615.399.7499

    Website | Blog | Facebook | LinkedIn

     

     




    Original Message


  • 3.  RE: Billing when GIP is being provided at a contracted facility in another county with different rates

    This message was posted by a user wishing to remain anonymous
    Posted 02-21-2026 01:55 AM
    This message was posted by a user wishing to remain anonymous

    As long as your license covers the GIP location of care, you would bill of off location of care. Most important and often overlooked, do you have a license to provide hospice care in that county? Sounds like you do so it should be straightforward with billing rate being specific to county of care location.

    Hope that helps!

    John

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    Original Message


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