Excluding Service from the Hospice Election

This webinar occurred on 3/26/26. Medicare uses modifiers or a condition code to exclude services from the hospice election. The data is for 2025’s last quarter, and this is one of our top denials. During this education, we will: • Define the modifiers GV and GW • Explain condition codes affecting the hospice election • Explain the data and why this is important Resources WPS SNAP (Secure Net Access Portal) User Manual https://www.wpsgha.com/tools/portal-u... Direct Date Entry (DDE) https://www.wpsgha.com/guides-resourc... HIPAA Eligibility Transaction System (HETS) https://www.cms.gov/data-research/cms... Medicare Benefit Policy Manual, Chapter 9, Sections 20.1 and 40.1.3.1 https://www.cms.gov/Regulations-and-G... Medicare Benefit Policy Manual, Chapter 9, Section 20.2.1 https://www.cms.gov/Regulations-and-G... Medicare Managed Care Manual, Chapter 4 - Benefits and Beneficiary Protections, Section 10.4 https://www.cms.gov/regulations-and-g... Chapters 00:00 Intro 02:52 Coverage Basics 17:50 Claims Data 24:42 Excluding the Services 39:47 Questions and Answers 54:20 Closing Comments