Georgia Medicaid Hospice Coverage Guide (2026)

Georgia Medicaid hospice coverage is one of the most comprehensive but most misunderstood Medicaid benefits in the state. Families often arrive at hospice late, after months of avoidable suffering, because they associate it with "giving up." Nursing facility residents and their families sometimes assume electing hospice means leaving the facility, when in fact a federal mechanism keeps them in place with full hospice support layered on top. Parents of seriously ill children frequently believe they must choose between fighting and comfort, when in fact federal law allows children to do both at once.

This guide walks through Georgia Medicaid hospice coverage in 2026: the legal foundation at the federal Medicaid hospice benefit and 42 CFR Part 418, the three eligibility requirements (Medicaid enrollment, terminal prognosis of six months or less, and voluntary hospice election), the four levels of care (routine home care, continuous home care, general inpatient, and inpatient respite), the interdisciplinary team services, the nursing facility room and board pass-through that lets NF residents stay in place while receiving hospice, the Affordable Care Act §2302 concurrent care exception for children under twenty-one, EPSDT pediatric hospice expansion, dual-eligible Medicare and Medicaid coordination, the federal hospice aggregate cap, benefit periods and recertification requirements, election and revocation procedures, six worked examples, fifteen common mistakes, an FAQ, and a complete contact list of major Georgia hospices and resources.

This is the canonical Georgia Medicaid hospice coverage playbook.

By Brevy Care Team · Last verified May 12, 2026

What hospice is and what it covers

Hospice is a comprehensive end-of-life care benefit for individuals with terminal illness who choose comfort-focused care instead of curative treatment for that illness. The philosophy emphasizes symptom management, psychosocial support, family involvement, and care delivered in the patient's preferred setting (home, nursing facility, or hospice inpatient unit).

The Medicaid hospice benefit is structured around four federally defined levels of care under 42 CFR 418.302, comprehensive interdisciplinary team services under 42 CFR 418.64, and an integrated payment system in which the hospice provider receives a per diem rate covering nearly all related services and supplies.

The four levels of care

Routine Home Care (RHC). The most common level by a wide margin. The patient receives periodic visits from the hospice interdisciplinary team in their home (which can include a nursing facility designated as the patient's home). The hospice provides nursing, social work, chaplaincy, home health aide, volunteer support, all hospice-related medications, all hospice-related DME and supplies, and 24-hour on-call nursing availability.

Continuous Home Care (CHC). For acute symptom crises at home that would otherwise require inpatient admission, continuous home care provides extended nursing presence per 24-hour period under federal CHC regulations, with a regulatory minimum share of that time delivered by an RN or LPN. CHC is reserved for true symptom emergencies and reverts to routine home care once the crisis resolves. Confirm the operative hour thresholds in current federal hospice guidance.

General Inpatient Care (GIP). For acute symptom management requiring intensive medical intervention, general inpatient care is delivered in a hospital, hospice inpatient unit, or skilled nursing facility with a hospice contract. GIP is appropriate for uncontrolled pain, severe dyspnea, intractable nausea or vomiting, terminal restlessness, or family caregiver collapse with no home alternative. Stays are typically short, and care reverts to routine home care when symptoms are controlled.

Inpatient Respite Care (IRC). For relief of family caregivers, respite provides short-stay inpatient hospice care per episode under federal regulation. The patient is admitted to a Medicare or Medicaid certified facility (nursing facility, hospital, or hospice inpatient unit) so the family caregiver can rest. Respite is one of the most underused levels of care; many families wait until they collapse before requesting it. Pull the current federal regulation for the specific consecutive-day cap.

The interdisciplinary team services

Under 42 CFR 418.64, hospice must provide a core set of services through an interdisciplinary team:

• Physician services. Hospice medical director plus attending physician oversight; palliative care consultation.
• Nursing services. RN case manager (required by regulation), LPN support, and twenty-four hour on-call nursing.
• Medical social services. Licensed social worker providing psychosocial support, resource coordination, and advance care planning.
• Counseling services. Spiritual care from a chaplain, federally required extended bereavement counseling for the family following the patient's death, and dietary counseling.
• Home health aide services. Personal care, bathing, hygiene support.
• Homemaker services. Limited household tasks supporting hospice care.
• Physical, occupational, and speech-language pathology. As needed for comfort and functional support.
• Volunteer services. Required by 42 CFR 418.78, including companionship, errands, and family support.
• Hospice medications. All medications related to the terminal illness, provided by the hospice rather than through the Medicaid pharmacy benefit.
• Hospice DME and supplies. Hospital beds, wheelchairs, oxygen, wound care supplies, and incontinence supplies related to the terminal illness, provided by the hospice rather than through the Medicaid DME benefit.
• Bereavement services. Required for an extended period following the patient's death under federal hospice regulations.

What hospice does NOT cover

Hospice does not cover curative treatment for the terminal illness (with the major exception of concurrent care for children under twenty-one, described later). Hospice does not cover treatment for unrelated conditions; those continue under regular Medicaid. Hospice does not cover room and board in an assisted living facility or boarding home; the Medicaid room and board pass-through applies only to nursing facilities meeting Medicaid certification.

Eligibility for Georgia Medicaid hospice coverage

Three core requirements must be met simultaneously.

1. Medicaid enrollment

The member must be enrolled in Medicaid. Any eligibility category qualifies: aged, blind, and disabled categorical; institutional long-term care; HCBS waiver participants; dual eligibles; Pathways to Coverage adults; pregnant women; and children. Standard Medicaid eligibility rules apply throughout the hospice stay.

2. Terminal prognosis of six months or less

Two physicians must certify that the patient has a terminal prognosis with life expectancy of six months or less if the disease runs its normal course. The initial certification is provided by the hospice medical director and the patient's attending physician. Recertification is required at the end of each benefit period.

Common terminal diagnoses leading to hospice in Georgia include cancer (the most common), dementia (advanced Alzheimer's, vascular dementia, frontotemporal dementia at FAST 7), heart failure (Stage D, NYHA Class IV), COPD (Stage 4 with severe limitations), neurodegenerative diseases (ALS, end-stage Parkinson's, multiple sclerosis with severe disability), end-stage renal disease (dialysis discontinued or chronic kidney disease without dialysis), end-stage liver disease (Child-Pugh C cirrhosis with complications), and debility or failure to thrive in frail elderly.

3. Voluntary hospice election

The patient (or legal representative) must voluntarily sign a hospice election statement under 42 CFR 418.24. The election waives curative treatment for the terminal illness and related conditions. It does NOT waive treatment for unrelated conditions. The patient may revoke the election at any time without penalty.

Benefit periods

Under 42 CFR 418.21, hospice care is divided into benefit periods:

• First benefit period: ninety days
• Second benefit period: ninety days
• Subsequent benefit periods: sixty days each, unlimited number

At the end of each benefit period, the physician must recertify continued terminal prognosis. Beginning with the third benefit period, a face-to-face encounter with the hospice physician or nurse practitioner is required within thirty days prior to recertification.

The hospice election and revocation

The election statement under 42 CFR 418.24 must include identification of the designated hospice provider, acknowledgment that the patient understands hospice care is palliative, acknowledgment that election waives curative treatment for terminal illness and related conditions, the effective date of election, and the patient's or representative's signature.

Revocation

Under 42 CFR 418.28, the patient or representative may revoke the election at any time. Revocation must be in writing. Once revoked, the patient returns to regular Medicaid benefits. The patient may re-elect hospice later if eligibility continues. There is no penalty for revocation, and there is no limit on the number of times a patient may elect, revoke, and re-elect.

Changing hospice providers

Under 42 CFR 418.30, the patient may change to a different hospice provider once per benefit period. A change of hospice does not count as a revocation; the new hospice assumes care immediately.

Discharge from hospice

Under 42 CFR 418.26, the hospice may discharge a patient only in limited circumstances: the patient moves out of the hospice's service area; the hospice can no longer meet the patient's needs; the patient becomes ineligible (no longer meets the terminal prognosis criterion); or, rarely, for cause due to safety reasons. Discharge for cause is subject to appeal.

The 95% nursing facility room and board pass-through

This is one of the most important and most misunderstood aspects of Medicaid hospice.

How it works

When a Medicaid hospice patient resides in a nursing facility, the payment structure under 42 USC 1396a(a)(13)(B) operates as follows:

1. The hospice provides hospice services (the four levels of care, interdisciplinary team services, hospice-related medications, DME, and supplies).
2. The nursing facility provides room, board, and general nursing facility services (custodial care, dietary, housekeeping, social services, activities, supervisory nursing).
3. Medicaid pays the hospice the applicable hospice per diem (most days at the RHC rate; consult the current CMS hospice payment rate file and the Georgia DCH fee schedule for the wage-adjusted Georgia figure).
4. Medicaid ALSO pays the hospice an additional NF room and board payment equal to ninety-five percent of what the NF would have received from Medicaid had hospice not been elected.
5. The hospice then pays the NF the room and board pass-through.

The financial flow is: Medicaid → hospice → NF.

Why this matters

• Nursing facility residents can elect hospice without losing their NF placement.
• The NF retains ninety-five percent of its usual Medicaid revenue, so it does not have a financial incentive to discharge hospice patients.
• The patient has hospice symptom management AND NF custodial support layered together.
• This configuration is the most common Medicaid hospice placement for end-stage dementia, advanced heart failure, frailty, and other slowly progressive terminal conditions.

The patient's personal needs allowance continues

A nursing facility resident on hospice continues to owe patient liability to the NF in the same monthly amount as before hospice. Patient liability equals income (typically Social Security) minus the personal needs allowance minus any Medicare Part B premium and other allowable deductions. The flow is: member → NF for patient liability; Medicaid → hospice → NF for the 95% pass-through; together these cover the NF's room and board.

Concurrent care for children under 21 (ACA §2302)

Section 2302 of the Affordable Care Act fundamentally changed pediatric Medicaid hospice.

What changed

For adults, hospice election waives curative treatment for the terminal illness. ACA §2302 created a federally required exception: Medicaid children under twenty-one may receive BOTH curative treatment AND hospice services concurrently for the same terminal illness.

Practical implication

A child with terminal cancer on hospice can simultaneously receive:

• Chemotherapy infusions or other curative-intent treatments
• Inpatient hospital admissions for active treatment
• Surgery, radiation, or experimental therapies
• AND the full hospice interdisciplinary team services
• AND symptom management
• AND family support
• AND bereavement services for the family after the child's death

Hospice does not have to be revoked in order to continue active treatment. Active treatment does not have to be foregone in order to receive hospice support.

Why it matters

Pediatric cancer, complex congenital conditions, and other terminal pediatric diagnoses often have uncertain timelines. Families face the impossible question of when to "switch from fighting to comfort." ACA §2302 dissolved that binary. Families can pursue both simultaneously while the child remains terminally ill. Georgia implements concurrent care consistent with ACA §2302, and most pediatric oncology programs in the state (Children's Healthcare of Atlanta Aflac Cancer Center, Augusta University Children's Hospital Georgia, regional pediatric oncology programs) coordinate hospice care with continued active treatment.

EPSDT pediatric hospice expansion

In addition to ACA §2302 concurrent care, the EPSDT mandate requires Georgia Medicaid to cover all medically necessary services for children. This expands pediatric hospice beyond adult standards in several ways: higher per diem reimbursement where needed to address medical complexity; specialty pediatric pain management and symptom care; expanded respite hours when family caregiver support needs are intense; and coordination with EPSDT's broader benefit array including pediatric private duty nursing, durable medical equipment, and behavioral health.

Dual eligibles and Georgia Medicaid hospice coverage

For dual eligibles, Medicare Part A is the primary payer for hospice care.

Medicare hospice as primary

Medicare hospice covers all four levels of care, the interdisciplinary team services, hospice-related medications, hospice-related DME and supplies, and routine medical care related to the terminal illness. Patient cost-sharing under Medicare hospice is limited: modest coinsurance on hospice-related medications and on inpatient respite care, and no coinsurance for routine home care or continuous home care.

Important: adult Medicare beneficiaries do NOT receive concurrent care. The ACA §2302 concurrent care exception applies only to Medicaid children under twenty-one. Adult Medicare hospice election waives curative treatment for the terminal illness in the traditional way.

Medicaid wraparound for dual eligibles

For dual eligibles on Medicare hospice, Medicaid:

1. Pays the 95% nursing facility room and board pass-through if the patient is in a NF
2. Pays Medicare hospice cost-sharing for QMB-eligible duals
3. Continues to cover services unrelated to the terminal illness
4. Maintains the personal needs allowance structure for NF residents

A common misconception is that Medicaid stops paying anything when a dual eligible elects Medicare hospice. That is incorrect. The NF room and board pass-through and the unrelated condition coverage are major continued Medicaid responsibilities.

The hospice cap

To prevent inappropriate long-stay hospice utilization, both Medicare and Medicaid impose an aggregate cap on payments per hospice per cap year under 42 USC 1395f(i)(2)(B) and 42 CFR 418.309.

How the cap works

The cap is calculated as: number of beneficiaries served by the hospice in the cap year, multiplied by the per-beneficiary cap amount published by CMS annually, giving the aggregate cap. Payments above the aggregate cap must be returned to the payer.

How this affects members

Hospices managing large numbers of long-stay patients risk exceeding the cap. Some hospices specialize in shorter-stay cancer patients; others have higher tolerance for long-stay dementia patients. Members with prognoses that could exceed six months should be transparent about clinical trajectory; the right hospice will admit and continue care as long as continued recertification is supported.

Levels-of-care transitions in practice

The four levels of care are not static. A patient on routine home care may experience an acute crisis requiring continuous home care, then return to routine; another crisis may require general inpatient care followed by routine; a family may use respite once or twice during the hospice stay; and the patient may move between levels as clinically appropriate.

The hospice interdisciplinary team is responsible for managing these transitions in collaboration with the patient and family. Continuous on-call nursing availability (twenty-four hours per day) ensures families can reach the hospice for assessment and level-of-care change at any time.

Six worked examples

The framework comes alive in specific cases.

Example 1: Eleanor Roberts, 84, end-stage Alzheimer's in nursing facility

Eleanor, age eighty-four, has end-stage Alzheimer's disease at FAST stage 7. She has lost ambulation, swallowing function, and meaningful verbal communication. She lives in a Medicaid-certified nursing facility (Manor Care of Roswell). Her family is considering hospice.

Coverage pathway:

1. The NF social worker discusses hospice with the family.
2. The family meets with Hospice of the South for an evaluation.
3. The hospice medical director conducts a comprehensive evaluation at the NF.
4. The hospice medical director and Eleanor's primary care physician both certify terminal prognosis based on FAST 7 status, weight loss, recurrent aspiration pneumonia, and dependence in all ADLs.
5. Eleanor's daughter signs the hospice election as her power of attorney.
6. Eleanor remains at Manor Care.
7. Hospice of the South provides RN case manager visits twice weekly, HHA visits five times weekly, weekly chaplain visits, biweekly social worker visits, all hospice medications (scheduled acetaminophen, PRN morphine for dyspnea, scopolamine patch for secretions, PRN lorazepam for agitation), and a hospital bed, wheelchair, and oxygen as needed.
8. Medicaid pays Hospice of the South the RHC per diem plus the 95% NF room and board pass-through.
9. Hospice of the South pays Manor Care the room and board pass-through.
10. Eleanor pays Manor Care her patient liability each month (Social Security income minus the personal needs allowance and applicable Medicare Part B premium).
11. Eleanor passes away four months later.
12. The family receives federally required extended bereavement counseling.

Total cost to Eleanor's family beyond ongoing patient liability: $0.

Example 2: Robert Park, 78, ALS at home with a continuous home care episode

Robert, age seventy-eight, has ALS with progressive weakness. He elected hospice three months ago at home with his wife as primary caregiver.

Routine home care baseline:

1. Hospice Atlanta provides RN visits twice weekly, HHA three times weekly, weekly chaplain visits, and monthly social work visits.
2. All ALS medications, BiPAP equipment, hospital bed, and wheelchair are provided through hospice.
3. Robert's wife handles primary caregiving with hospice support.

Acute symptom crisis (CHC):

1. Robert develops sudden severe respiratory distress at 4 PM on a Sunday.
2. His wife calls the hospice on-call line.
3. The RN is dispatched within ninety minutes.
4. The RN finds Robert in acute respiratory failure.
5. Continuous home care is initiated with continuous nursing presence, morphine titration for dyspnea, BiPAP optimization, and family support.
6. CHC continues at eighteen hours per day for three days.
7. Medicaid covers the CHC for three days.
8. Robert stabilizes on optimized BiPAP and pain regimen.
9. He returns to routine home care.

Cost to the Park family: $0 (Medicare primary; Medicaid pays no cost-sharing for QMB dual eligible).

Example 3: Tasha Williams, 8, glioblastoma with concurrent care

Tasha, age eight, has recurrent glioblastoma multiforme after initial surgery and radiation. Her oncology team at Children's Healthcare of Atlanta initiates a clinical trial chemotherapy regimen with palliative intent.

Coverage pathway:

1. The family meets with the Children's complex care palliative team.
2. Pediatric hospice referral is made to Visiting Nurse Health System Atlanta's pediatric hospice program.
3. Two physicians certify terminal prognosis (less than six months even with continued treatment).
4. The family signs the hospice election.
5. Under ACA §2302 concurrent care, Tasha continues chemotherapy infusions at the CHOA Aflac Cancer Center (curative intent), inpatient admissions for chemotherapy administration, and hospital-based care for treatment-related complications.
6. Simultaneously, Tasha receives pediatric hospice services: a pediatric hospice RN case manager, a child life specialist (the pediatric equivalent of social work), a family-focused chaplain, symptom management for pain, nausea, and anxiety, family bereavement preparation, and sibling support services.
7. All hospice-related medications, DME, and supplies are covered by hospice per diem.
8. Curative chemotherapy continues to be billed by CHOA to Medicaid outside the hospice benefit; this is the concurrent care exception.
9. The family receives federally required bereavement support after Tasha's death.

Total cost to the family: $0 (EPSDT no cost-sharing for children under twenty-one).

Example 4: David Carter, 62, end-stage COPD on home hospice

David, age sixty-two, has Stage 4 COPD. He is on continuous home oxygen, has had multiple hospitalizations for exacerbations in the past twelve months, and his pulmonologist estimates a six-month prognosis.

Coverage pathway:

1. The pulmonologist refers David to Compassus Hospice.
2. The hospice medical director and the pulmonologist both certify terminal prognosis.
3. David signs the hospice election.
4. Compassus provides RN case manager visits weekly initially and then twice weekly as needed, HHA visits three times weekly, monthly social worker visits, and chaplain visits on request.
5. All COPD medications and hospice-related medications are provided through hospice.
6. Oxygen, nebulizer, and BiPAP are provided through hospice DME (not the Medicaid DME benefit).
7. David lives five months on hospice.
8. He has two general inpatient episodes during his course: one for severe dyspnea crisis lasting four days and one for terminal symptoms in his final week.
9. The family receives federally required bereavement support.

Cost to David: $0 (full Medicaid coverage).

Example 5: Maria Hernandez, 55, breast cancer with hospice revocation

Maria, age fifty-five, has metastatic breast cancer. She enrolled in hospice two months ago when bone metastases caused severe pain and her prognosis was estimated at four to six months.

Coverage pathway (initial):

1. Heart to Heart Hospice provides routine home care services.
2. Pain is controlled with sustained-release morphine and breakthrough oxycodone.
3. Symptoms stabilize after six weeks. Maria reports improved quality of life and energy.

Decision to revoke:

1. Maria meets with her oncologist, who identifies a new targeted therapy (trastuzumab deruxtecan) for HER2-positive metastatic disease.
2. Maria wants to try the therapy with curative intent.
3. Maria signs the hospice revocation statement.
4. Heart to Heart Hospice discharges her.
5. Maria returns to standard Medicaid benefits.
6. Oncology initiates trastuzumab deruxtecan.
7. Maria responds well to treatment. Her prognosis extends to eighteen-plus months.
8. Maria may re-elect hospice later if her disease progresses.

There is no penalty for revocation. The patient may re-elect hospice in any future benefit period. All Medicaid benefits resume immediately upon revocation. The hospice cannot prevent revocation.

Example 6: Wallace Brown, 88, dementia on hospice with unrelated hip fracture

Wallace, age eighty-eight, lives in Greenbriar Health Care Center, a Medicaid nursing facility. He has advanced dementia and elected hospice eight months ago through Brighter Days Hospice. He recently sustained a hip fracture from a fall.

Coverage pathway:

1. Wallace's terminal illness (dementia) is managed by Brighter Days Hospice.
2. NF custodial care is managed by Greenbriar.
3. Hospice receives the hospice RHC per diem plus the 95% NF room and board pass-through from Medicaid.
4. Greenbriar receives the NF room and board pass-through from the hospice.

The hip fracture is UNRELATED to dementia (the terminal illness):

1. Wallace is transported to the hospital for fracture evaluation.
2. The orthopedic surgeon recommends surgical repair (dynamic hip screw).
3. The family decides on surgical repair for pain management.
4. The hospital admission, surgery, and post-acute recovery are covered by Medicaid REGULAR benefits, not hospice. The hip fracture is unrelated to dementia.
5. Hospice continues to cover dementia-related symptoms throughout the hospitalization.
6. After hospital discharge, Wallace returns to Greenbriar and continues with Brighter Days Hospice.
7. Hospice now also manages post-surgical pain because pain management is a comfort-care concern.
8. Wallace continues with combined NF and hospice care until he passes three months later.

Cost to the Brown family: $0 beyond ongoing patient liability for the NF.

Fifteen common mistakes

1. Assuming hospice means "giving up." Hospice is comfort-focused care. Many patients live longer on hospice than expected due to active symptom management and the absence of treatment toxicities.

2. Forgetting that hospice election waives curative treatment for the terminal illness only. Unrelated conditions are still covered by regular Medicaid (a hip fracture in a dementia hospice patient, a UTI in a cancer hospice patient).

3. Not knowing about concurrent care for children. Under ACA §2302, children under twenty-one may receive BOTH curative treatment AND hospice for the same terminal illness. This is one of the most important pediatric Medicaid protections families do not learn about until it is too late.

4. Misunderstanding the 95% NF room and board pass-through. When a nursing facility resident elects hospice, Medicaid pays the hospice the per diem PLUS ninety-five percent of the NF's Medicaid rate. The hospice then pays the NF. The NF does not lose substantial revenue.

5. Skipping the recertification. At the end of each federal hospice benefit period, the physician must recertify continued terminal prognosis. Without recertification, hospice payment stops. The hospice manages this process, but family awareness helps.

6. Not knowing continuous home care is available. For acute symptom crises at home, CHC provides up to twenty-four hours of nursing care to avoid inpatient admission. Many families do not know to ask for it.

7. Forgetting respite care. Short-stay inpatient respite per episode under federal hospice regulations allows family caregivers to recover. The benefit is consistently underused.

8. Confusing hospice with palliative care. Palliative care is symptom management at any disease stage. Hospice is end-of-life care for patients with terminal prognosis. The two overlap but are distinct programs with different eligibility criteria.

9. Assuming hospice is only for the last days or weeks. Hospice serves patients with six-months-or-less prognoses. Patients may be on hospice for many months with comprehensive support.

10. Forgetting bereavement services. Hospice provides federally required bereavement support to the family after the patient's death. Many families do not realize this is included and underutilize it.

11. Trying to use the Medicaid pharmacy benefit for hospice medications. Hospice-related medications come from the hospice (covered in the per diem), not from the SPBM pharmacy benefit. Trying to fill at a retail pharmacy with the Medicaid card will fail.

12. Letting patient liability lapse for NF residents on hospice. The NF resident continues to owe patient liability monthly. The 95% pass-through and the hospice per diem cover the NF's other costs, but the patient liability remains the member's responsibility.

13. Not appealing for-cause discharge. Hospices may discharge for cause only in specific circumstances. Members and families have appeal rights.

14. Missing pediatric hospice resources. Visiting Nurse Health System Atlanta, Hospice Savannah, and other Georgia hospices provide specialized pediatric services. The Children's Healthcare of Atlanta complex care team coordinates with hospice providers.

15. Choosing a hospice without checking specialty experience. Not all hospices serve all patient populations equally well. Pediatric, ALS, dementia, and pediatric oncology each benefit from hospices with established experience in those populations.

A few more common questions:

What does hospice cover? All hospice-related medical care, including nursing, social work, chaplaincy, home health aide, all medications related to the terminal illness, DME and supplies related to the terminal illness, volunteer services, and federally required extended family bereavement support after the patient's death.

Can I revoke hospice if I want curative treatment again? Yes. You may revoke hospice at any time with no penalty. You may re-elect hospice in any future benefit period if you remain eligible.

How long can I stay on hospice? Indefinitely, as long as you continue to meet the terminal prognosis criteria. Benefit periods are ninety days, ninety days, then sixty-day periods unlimited. Each requires physician recertification of continued terminal prognosis.

Does hospice provide a hospital bed and oxygen? Yes. The hospice provides all DME and supplies related to the terminal illness as part of the per diem. The Medicaid DME benefit does not apply for hospice-related equipment.

What if I have Medicare AND Medicaid? Medicare is primary for hospice. Medicaid wraps around to pay any Medicare cost-sharing (for QMB-eligible duals) and to pay the NF room and board pass-through if you are in a NF.

A note on accuracy

This guide reflects Georgia Medicaid hospice coverage as it stands in 2026. CMS reimbursement rates, regulatory standards, and program parameters change continuously. We at brevy.com update these guides on regular review cycles, but always verify program specifics with the hospice provider, the nursing facility (if applicable), or DCH before relying on them for clinical or financial decisions.

If you are facing a medical emergency, call 911 or go to your nearest emergency department. The information in this guide is general education and is not a substitute for direct consultation with your healthcare provider, hospice team, Medicaid case manager, or a licensed attorney.

Find personalized help navigating Georgia Medicaid hospice coverage at brevy.com.