Hospice Prescription Drug Reporting Table

When reporting prescription drugs on hospice claims, there are differences based on the type of administration. The table below provides information on how to report these drugs.

Medication Form (method of administration)
Revenue Code
HCPCS
 
Revenue Code Units
NDC
 
NDC Quantity (per fill)
NDC Unit of Measure
NDC Example
Non-injectable (solution, liquid, suspension)
0250
N/A
1*
Required
Quantity of solution, liquid, suspension
ML
  • 3 ml bottle of Albuterol 0.083% inhalation solution, NDC qty = 3
  • 0.5 ml of Morphine Sulfate 20 mg/ml oral solution, NDC qty = 0.5
Non-injectable (Cream, Ointment or Lotion)
0250
N/A
1*
Required
Quantity of cream, ointment or lotion
GR or ME
  • 5 gm tube of cream,
    NDC qty= 5
  • 60 ml bottle of 1% lotion, NDC qty = 60
Non-injectable (powder packet)
0250
N/A
1*
Required
# of vials/bottles
UN (administered in powder form)
  • One bottle of Zmax 2gm oral suspension,
    NDC qty = 1
Non-injectable (powder – requires reconstitution)
0250
N/A
1*
Required
Quantity of powder
ML
  • 150 ml bottle of Amoxicillin (powder for reconstitution) 250mg/ml, NDC qty = 150
Non-injectable
(tablet, capsule)
0250
N/A
1*
Required
# of tablets, capsules per fill
UN
  • Two Cephalexin 500mg oral capsules,
    NDC qty = 2
  • One Lorazepam 0.5mg oral tablet, NDC qty = 1
Non-injectable (suppository)
0250
N/A
1*
Required
# of suppositories per fill
UN
  • One 25 mg suppository, NDC qty = 1
Non-injectable
(Transdermal Patches)
0250
N/A
1*
Required
# of patches
UN
  • One Duragesic 50mcg/hr patch, NDC qty = 1
Injectable
0636
Required
Amount filled based on HCPCS definition
(ex. HCPCS = 100 mg, fill = 200, units reported as 2)
N/A
N/A
N/A
N/A
Infusion pump drug
0294
Required
Amount filled based on HCPCS definition
(ex. HCPCS = 100 mg, fill = 200, units reported as 2)
N/A
N/A
N/A
N/A
* The 0250 revenue code line only requires a valid value (i.e., whole number) because the actual units (quantity) are reported in the NDC field. Providers can report a unit of "1" or any other value that may assist them internally. 

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