CMS Treatment Planning & Management 3

Question 1

A Medicare beneficiary is diagnosed with a terminal illness with a prognosis of 6 months or less. Which Medicare benefit provides comprehensive end-of-life care including pain management and counseling?

Accepted Answer

Medicare hospice benefit

Answer

The Medicare hospice benefit covers comprehensive comfort-focused care for terminally ill beneficiaries who forgo curative treatment.

Question 2

A patient on Medicare has been approved for hospice care. Which of the following services would NOT be covered under the hospice benefit for the terminal diagnosis?

Accepted Answer

Curative chemotherapy for the terminal illness

Answer

Curative treatment for the terminal diagnosis is not covered under the hospice benefit; beneficiaries must forgo curative care for the terminal condition.

Question 3

What is the maximum number of days Medicare covers in an SNF at full benefit (no copayment) during a benefit period?

Accepted Answer

20 days

Answer

Medicare covers days 1–20 in an SNF with no coinsurance; days 21–100 require a daily coinsurance amount.

Question 4

A Medicare beneficiary needs an MRI to plan cancer treatment. The ordering physician did not obtain prior authorization from the Medicare Advantage plan. What is the most likely outcome?

Accepted Answer

The claim may be denied and the beneficiary could be liable for the cost

Answer

Without required prior authorization, a Medicare Advantage plan can deny payment, potentially leaving the beneficiary responsible for the cost.

Question 5

Which type of Medicare-covered therapy focuses on restoring a patient's ability to perform daily activities such as dressing and cooking after a debilitating illness?

Accepted Answer

Occupational therapy

Answer

Occupational therapy helps patients regain skills needed for activities of daily living and is covered under Medicare Part B.

(CMS) Certified Medicare Specialist Practice Test

(CMS) Certified Medicare Specialist Practice Test

CMS Treatment Planning & Management 3