Long Term Care Share of Cost

Saturday, Oct. 15th 2011 6:38 AM

Providers receiving an eligibility verification message (see following example) that indicates a subscriber has an LTC SOC should not  clear the SOC online.  Subscribers with aid codes 13, 23, 53 and 63 must have their LTC SOC cleared on the claim.  The LTC facility  includes the LTC SOC amount for Medi-Cal-covered services on the  Payment Request for Long Term Care (25-1).  Refer to the Share of  Cost (SOC):  25-1 for Long Term Care section in the Part 2 manual for additional information.   When billing for room and board (revenue code 0658), the Hospice provider includes the LTC SOC amount for Medi-Cal-covered services on the UB-04 claim form.  Refer to the Hospice Care:  General Billing Instructions section in the Part 2 manual for additional information.

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