HCPCS Q5001: Hospice Care in the Patient's Home or Residence
Q5001 is the HCPCS site-of-service code for hospice or home health care provided in the patient's home or residence. It does not describe a service. Hospices pair it with a level-of-care revenue code, and home health agencies add it once for the location of the first visit.
Written by Salman Saeed, CEO and Co-Founder · Reviewed by a Certified Medical Coder · Last reviewed October 2026In short: Q5001 tells Medicare where the care happened. A hospice reports it on every home level-of-care line, such as revenue code 0651 with units in days, and starts a new line when the level or location changes. A home health agency reports it once, with one unit and a nominal charge, beside the first visit.
What Does HCPCS Q5001 Report?
Q5001 is a HCPCS Level II code. The CMS code file reads "Hospice or home health care provided in patient's home/residence." It names a place and never replaces the level-of-care line it sits beside.
| Item | Value in the CMS files |
|---|---|
| Short label CMS uses | Hospice or home hlth in home |
| Added to the HCPCS file | January 1, 2007 (last action effective July 1, 2013) |
| Termination date | None shown in the October 2026 file |
| Medicare coverage code | D, special coverage instructions apply |
| HCPCS processing note 0133 | See online manual 100-02.9, the hospice chapter of the Benefit Policy Manual |
| Physician fee schedule status (RVU26D) | E, excluded from the fee schedule by regulation |
| Practitioner MUE table, effective October 1, 2026 | No row for Q5001 |
How Does Q5001 Sit on a Hospice Claim?
Chapter 11, section 30.3 of the Claims Processing Manual says hospices must report a HCPCS code with each level-of-care revenue code, 0651, 0652, 0655 and 0656, to show the type of service location. Q5001 is the code for the patient's home or residence.
| Level of care | Revenue code | Units |
|---|---|---|
| Routine home care | 0651 | Days |
| Continuous home care | 0652 | 15-minute increments, a separately dated line for each day |
| Inpatient respite and general inpatient | 0655 and 0656 | Days |
The line date is the earliest date at that level and location. The manual's own example is a March claim of all routine home care at home, reported as 0651, Q5001, 03/01, 31 units. Medicare counts days from the election, so the high rate for days 1 to 60 and the low rate after day 60 can both apply inside that one line.
A new line starts when the level or location changes. Per the manual, a patient who spends part of the month at home and part in an assisted living facility gets one 0651 line with Q5001 and another with Q5002, each with its own days. The visit lines for nursing, therapy and aides do not need a Q code.
Which Q Code Replaces Q5001 When the Location Is Not Home?
| Code | Location in chapter 11 |
|---|---|
| Q5001 | Patient's home or residence |
| Q5002 | Assisted living facility |
| Q5003 | Nursing long term care facility or non-skilled nursing facility |
| Q5004 | Skilled nursing facility (SNF) |
| Q5009 | Place not otherwise specified |
| Q5010 | Hospice home care provided in a hospice facility |
Q5005 to Q5008 cover inpatient hospital, inpatient hospice facility, long term care hospital and inpatient psychiatric facility. Q5004 is limited to four SNF situations in the chapter, such as general inpatient care in a SNF. A nursing facility resident who does not meet them is coded Q5003. See hospice billing for levels of care and the election.
How Does a Home Health Agency Report Q5001?
Chapter 10, section 40.2 requires home health agencies to report where services were provided, using Q5001, Q5002 or Q5009. The agency adds a line with the same revenue code and date as the first visit, one of those codes, one unit and a nominal covered charge, such as a penny.
If the location changes during the period of care, the agency adds a new line with the first visit in the new location. The G-codes on the visit lines, such as G0299 and G0151, still carry the visit itself. Home health billing shows the rest of the claim.
How Is Q5001 Paid, and What Does KX Do?
Q5001 has no payment of its own. The daily rate comes from the level-of-care revenue code, and section 30.1 says a hospice day billed as routine home care in the first 60 days of an election is paid at the high rate and from day 61 at the low rate.
Modifier KX goes on the Q code. A hospice that believes exceptional circumstances caused a late notice of election (NOE) files the claim with occurrence span code 77 for the provider-liable days and adds KX to the Q code on the earliest dated level-of-care line. That prompts the MAC to request documentation. If approved, the MAC removes the provider-liable days; if not, it processes the claim as submitted.
When days are non-covered for a late NOE and no exception applies, the hospice splits the level into two lines. One 0651 line carries the earliest non-covered date, the non-covered units and charges, and a second carries the first covered date.
Which UB-04 Fields Carry Q5001?
Q5001 is a location line, not a service. FL 42 holds the level-of-care revenue code, FL 44 holds Q5001, FL 45 holds the date and FL 46 holds the days. A new line begins when the level or location changes. Chapter 25 includes the hospice type of bill 081X in its dated-line rule, so each line needs its own date.
RVU26D gives Q5001 status E, with no RVUs or payment amounts, and the practitioner MUE table has no row for it.
Example: A hospice patient is at home for 10/01 to 10/14 and then moves to a nursing facility. The claim shows one Q5001 line for the 14 days at home and a second line from 10/15 with the new location. One line for the whole month would hide the change.
Which Denials Involve Q5001 Claims?
| Situation | Remittance |
|---|---|
| Days not covered because the NOE was late | Group code CO, CARC 96, RARC MA54, per chapter 11 |
| Another provider bills related care for an enrolled patient | CO-B9, the patient is enrolled in a hospice |
| Nursing, therapy or aide visit lines under a level of care | Remitted CO-97 with no remark code, included in the daily rate |
X12 defines CARC 96 as non-covered charges, with at least one remark code required. If these denials keep coming back, our denial management team can work them.
Related Codes
- HCPCS Level II quarterly update, October 2026 alpha-numeric file · CMS
- Physician Fee Schedule relative value files, RVU26D (October 2026) · CMS
- Medicare NCCI Medically Unlikely Edits, practitioner services table, effective 10-01-2026 · CMS
- Medicare Claims Processing Manual, Chapter 10: Home Health Agency Billing · CMS
- Medicare Claims Processing Manual, Chapter 11: Processing Hospice Claims · CMS
- Medicare Claims Processing Manual, Chapter 25: Completing and Processing the Form CMS-1450 Data Set · CMS
- Claim Adjustment Reason Codes · X12
- Remittance Advice Remark Codes · X12
- Medicare Claims Processing Manual, Chapter 26: Completing and Processing Form CMS-1500 Data Set · CMS
- Medicare Claims Processing Manual, Chapter 25: Completing and Processing the Form CMS-1450 Data Set · CMS
We check every rule, code and deadline against the official source. See our editorial policy.
Common Questions
Straight answers from the team that does the work.
Ask a billing lead directly. A 20-minute call, Monday to Friday, 9am to 5pm Eastern.
01How do I bill hospice care in the home (Q5001)?
Report revenue code 0651 for routine home care with Q5001, the earliest date at that level and location, and units in days. Add a new line whenever the level of care or location changes. For continuous home care, use 0652 with a dated line each day and 15-minute units.
02Is Q5001 only for hospice claims?
No. The descriptor covers hospice or home health care in the patient's home. Home health agencies report Q5001, Q5002 or Q5009 once for the first visit location, with one unit and a nominal charge, and add a new line if the location changes during the period.
03Does Q5001 go on each visit line?
No. Chapter 11 says the service location codes are not required on the revenue code lines that describe visits. Nursing, therapy and aide visits report their own G-codes, such as G0299, while Q5001 belongs on the level-of-care line for the location where care was given.
04What if a hospice patient moves to an assisted living facility mid month?
Report two routine home care lines under revenue code 0651. One carries Q5001 with the days at home, and the other carries Q5002 with the days in the assisted living facility. Each line is dated with the first day at that location.
05What does KX do on a Q5001 line?
KX asks Medicare to review an exception for a late notice of election. It goes on the Q code of the earliest dated level-of-care line, with occurrence span code 77 on the provider-liable days. The MAC requests documentation before deciding.
Hospice Lines Missing a Location Code?
We check each level-of-care line for its Q code, units and dates before the claim is sent.