Hospices are to Report Post-Mortem Visits with the Modifier PM

Medicare is finding through the Medical Review process that hospices are not correctly reporting post-mortem visits with the modifier PM on their claims. These reporting errors will be counted as an error in the review process and may cause service intensity add-on (SIA) payments to be applied incorrectly on the claim. 

Hospices shall report visits and length of visits (rounded to the nearest 15-minute increment), for nurses, aides, social workers and therapists who are employed by the hospice, that occur on the date of death, after the patient has passed away, with modifier PM. The reporting of post-mortem visits, on the date of death, should occur regardless of the patient’s level of care or site of service. Post-mortem visits occurring on a date subsequent to the date of death are not to be reported.

Date of death is defined as the date of death reported on the death certificate. Hospices shall report hospice visits that occur before death on a separate line from those which occur after death.

For example, assume that a nurse arrives at the home at 9 p.m. to provide routine home care (RHC) to a dying patient, and that the patient passes away at 11 p.m. The nurse stays with the family until 1:30 a.m. The hospice should report a nursing visit with eight 15-minute time units for the visit from 9 p.m. to 11 p.m. On a separate line, the hospice should report a nursing visit with a PM modifier with four 15-minute time units for the portion of the visit from 11 p.m. to midnight to account for the 1 hour post mortem visit.

If the patient passes away suddenly, and the hospice nurse does not arrive until after his death at 11 p.m., and remains with the family until 1:30 a.m., then the hospice should report a line item nursing visit with a PM modifier and four 15-minute increments of time as the units to account for the 1 hour post mortem visit from 11 p.m. to midnight.

Resource: Medicare Claims Processing Manual, Chapter 11 — Processing Hospice Claims (PDF), section 30.3 — Data Required on the Institutional Claim to A/B MAC (HHH).